Showing posts with label CSHM. Show all posts
Showing posts with label CSHM. Show all posts

Tuesday, June 09, 2015

Wondering how the Small Smiles Dental Malpractice Settlement Stands?

This pretty much covers where the settlement is today.

Small Smiles Settlement as it stands June 2010

Tuesday, May 26, 2015

DeRose / Padula Family - FORBA files Objection to $39M Settlement

So today was the deadline to file Objections in the $39M Small Smiles Dental Center's settlement. I'm perplexed. How the hell did this thing even get filed?!?! At least 3 Objections were filed today! Old FORBA (The DeRose/Padula family) don't like it, the victims don't like it (neither do I) and one Insurance Company doesn't like it! So who the hell liked it enough to call it "Settled" Honestly! Who was it?!?!?! Could it be the a select group of attorney's wanting their money and run, or the Trust Administrator who will snatch up a quick million or two within days of it's approval? Could it be AIG, who has filed so many pleadings courts have had to reprogram their systems or maybe AIG ran out of "stalking" attorneys to follow jurors around.

Apparently they know children will be seeking compensation for their abuses for years to come and low and behold, old man Dr. Adolph Padula and others have figured out they are included in the count of 333 dentists who will lose their malpractice coverage for all their misdeeds. Yeah, I laughed pretty hard at this one.

Creepy ole Aldoph Padula says his retroactive coverage is to last until the end of time. No wonder he's scared! 

 "The Objectors believe that some or all of the Claimants will continue pursuing claims against the Objectors which claims are covered by the insurance policies that are the
subject of the Motion and Settlement and Release Agreement.Upon information and belief, the Supplemental Extended Reporting Period Endorsement provides for a period of “unlimited duration” during which “claims” arising from “dental incidents” that occurred after the retroactive date (i.e., February 1, 2001) and before the end of the policy period (i.e.,September 26, 2010) may be reported under the Entities Policy." 

 Be sure to hit page 6 and 7 for the long list of clinics!! And note that it says "among others"...that a boat load of clinics!! One thing is for certain, these old boys haven't been enjoying their retirement as much as I bet they thought they would.

Continental Casualty filed an Objection as well.

It must have been a real party at the court today, down there in Nashville. 

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Objection filed opposing the $39M settlement for small victims of FORBA/CSHM’s Small Smiles Dental Centers

Actually there were at least 3 Objections filed today, this is just one.

Objection to $39M Settlement for victims of Small Smiles Dental Centers

Tuesday, February 17, 2015

CSHM, LLC (Small Smiles Dental Centers) Files for Chapter 7 Bankruptcy

February 17, 2015
Just 4 months after CSHM, LLC (Small Smiles Dental Centers) were Excluded from the Medicaid program, Michael F. Gries, the installed Chief Restructuring Officer, filed Chapter 7 Bankruptcy in Delaware Bankruptcy Court on February 5, 2015. (Case No. 15-bk-10206)
CSHM, LLC is the restructured company that emerged in June 2012 when Church Street Health Management (f/k/a FORBA) filed for Chapter 11 Bankruptcy February 20, 2012. (Case No. 12-bk-01573)
Church Street Health Management signed a 5 years Quality of Care Corporate Integrity Agreement in January 2010 (CIA) after a 3 year investigation by the feds that found billing fraud and gross mistreatment, overtreatment and failure to come close to meeting an acceptable standard of care treating the dental needs of children on Medicaid. They also agreed to pay $24 Million for their misdeeds; the Department of Justice was to received $14.2 Million and 21 states were to share $9.7 million and explained here on page 6.

In addition Church Street Health Management (f/k/a FORBA) signed a Corporate Integrity Agreement with the New York Office of Medicaid Inspector General. Agreeing to paying New York and additional $2.3 million.

After continued blatant disregard for the Quality of Care Corporate Integrity, consistent failures of inspections, a 1500 page bi-partisan 2012 Congressional Report  and various warnings by HHS-OIG, CSHM, LLC received notice they were Excluded from the Medicaid program in March 2014. However the government saw fit to allow CSHM, LLC to pilfer and plunder the Medicaid slush fund for an additional 6 months under an Exclusion Agreement.
This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.

Despite the “Quality of Care” issues as indicated by the classification of the type of Corporate Integrity Agreement they were under, and results of the Monitor’s monitoring, when CSHM received their Exclusion letter they claimed none of the clinics they own were effected it was just the management division of the company and issued a press release stating the centers different entities therefore not effected. HUH?

Here we are in 2015, 8 years since Small Smiles dental centers and their so called management company, CSHM were first investigated—it started in mid 2007— and it just past the anniversary of the 5 year CIA. Heck it expired two weeks ago—January 15, 2015.
According to the 31 page, 3 columns, list of Creditors filed February 5, 2015 they still owe various states their portion of the $24 million dollars. (a breakdown is below)  

They owe several “owner dentists”, support staff, and other dentists, as well as whistleblowers, dental boards, ad agencies, law firms, TV stations, court reporters, (for the numerous lawsuits in which they are involved), storage facilities,(wonder what’s hidden there), utility bills for their clinics, dental labs and insurance companies (hope they kept the Malpractice premiums up for all those dentists!), and every dental supply company in the country, and various management companies. (yep, the management company hires management companies)

Other notables were, Garrison Loan Agency who ponied up the dough to keep this scumbag company alive and kicking from 2012-2015 and the IRS.

Those missing for the list are David R. Wilson, CEO and other top executives, and Waller Landsden Law Group.  Hmmm… Pleadings indicate Wilson was paid $1,194,432.85 the year preceding the filing of the bankruptcy.

Other points of Interest in the initial documents:
Doc 2 Schedules of Assets and Liabilities,
Page 2, Item 3
—In accordance with the Exclusion Agreement, the Company divested itself of substantially all of the CSHM Assets through a series of sales between April and September 2014.  Included among the sale of the CSHM Assets, the Company sold certain assets to First Quality Management, Inc. (FQMI), pursuant that certain Asset Purchase Agreement, dated as of September 30, 2014.  Separately, the Company also entered into that certain Assignment and Assumption Agreement with FQMI, dated September 30, 2014, in connection with the assumption of six (six) MSA’s.  A breakdown of the other clinics can be found here, beginning on page 9.  Missing from that list is all the Colorado clinics except the Colorado Springs clinic.  Interesting, indeed.
So I was right when I posted about FQMI and the continued operations of Small Smiles Dental Centers. Current pleadings say they paid Dr. Paul Elkin $401,574.00 in the year proceeding this bankruptcy filing.  He’s the new head at FQMI according to his LinkedIn page.
Paul Elkin Linked In
Page 2, Item 4
—Additional assets were sold to employees of the Debtor in September 2014…
Wait, I thought the “owner dentists” were already “owners”, not employees!” (sarcasm)
Page 11 & 12
—1st. Lien Holder: Garrison Loan Agency Services, LLC – $37,500,000.00 initial loan, still owed $28,764,918.60;
—2nd Lien Holder: Garrison Loan Agency Services, LLC – $17,500,000.00 initial loan, still owed $17,786,714.00.
——Grand Total for Secured Creditor Garrison Loan Agency $46,551,633.00
Under Creditors Holding Unsecured Nonpiority Claims (Schedule F, page 15, of Doc 2) are all Medicaid Fraud Control Units Creditors and the amount:
Known 2010 Settlement Amounts
Due as of January 2015
1 MFCU of Alabama $463,028.00 $79,595.63
2 MFCU of Arizona $127,853.41
3 MFCU of Colorado $1,200,00.00 $616,099.66
4 MFCU of  Georgia             $288,910.84
5 MFCU of Idaho                   $46,687.18
6 MFCU of Indiana              $348,534.90
7 MFCU of Kansas               $517,959.60 $260,969.66
8 MFCU of Kentucky              $123,693.14 $22,484.43
9 MFCU of Maryland            $275,814.83
10 MFCU of Massachusetts  $726,035.97
11 MFCU of Nebraska             $270,000.00 $61,717.55
12 MFCU of Nevada         $83,402.83
13 MFCU of New Hampshire    $48,090.36
14 MFCU of New Mexico         $182,376.06
15 MFCU of New York $1.15M+ $2.3M     $3,450,000.00 $315,849.66
16 MFCU of DC                       $78,057.19
17 MFCU of Ohio                   $2,392,926.50 $502,185.04
18 MFCU of Oklahoma         $700,00.00 $355,411.82
19 MFCU of South Carolina  $471,779.92
20 MFCU of Texas                $546,000.00 $117,851.57
21 MFCU of Virginia              $228,616.76
22 Department of Justice                                $14,200,000.00 $12,966,496.00
23 Department of Justice                               $7,844,455.34
Grand Total $26,300,000.00 $26,049,276.61
According to the pleadings (Doc 8-1) Amended Schedule B Personal Property they have:
Assets:            $136,369.67
Liabilities:  $73,314,905.16

The 2010 Corporate Integrity Agreement
The DOJ said in 2010 “"We have zero tolerance for those who break the law to exploit needy children," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Illegal conduct like this endangers a child’s well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."
(cough, choke and puke, they have complete tolerance, encourage it, and are accomplices to it!)

Tuesday, September 30, 2014

It’s September 30, 2014

Today is the deadline for CSHM to have divested in all of the Small Smiles clinics.  Have they? Have the simply rebranded?

I don’t know.

Monday, September 15, 2014

Small Smiles Dental Centers: Countdown to Exclusion is Business as Usual

As the days count down to CSHM Exclusion from Medicaid becomes effective on September 30, 2014 I’m getting more and more reports that “lead” dentists of the individual Small Smiles clinics are “purchasing” their respective clinics. (Colorado clinics, New Mexico clinics and Indiana clinics just to name a few that have been reported.)

Since January 2010 the clinics have been visited by monitors and care continued decline to the point they were Excluded from Medicaid participation as of September 30.  Several reports from monitors found care unacceptable as dentists and staff continued to deliver substandard care as reported in the bipartisan Senate Report.

How can leaving same dentists in place improve the situation?

It is more than highly likely dentists who have been delivering the unacceptable care and treatment for years will continue with business as usual and children are still at great risk and taxpayers will continue to be fleeced.

The risk may be greater than ever.

Anyone think care will be better?

The dentists and clinic operations may not have the watchful eye of the government monitors or be bound by any Corporate Integrity Agreement with HHS-OIG.  That Agreement was made with CSHM, the management company of the Small Smiles dental centers. (another pitfall of corporate owned dentistry)

Tuesday, September 02, 2014

CSHM still up and running, business as usual

Linda Zoeller at CSHM in Nashville still has a job and still filing questionable legal documents for Small Smiles, now known as (file in the blank) Youth Dentistry.

This was filed just today in Colorado.

140902 Springs Smiles Youth Dentistry, PC

Sunday, August 03, 2014

Another Squabble with CSHM, Small Smiles Dental Centers and Owner Dentists—Small Smiles Reno—Who is extorting who?

I seldom tire of the spin found in legal pleading between owner dentists the illegal dental management companies such as CSHM but honestly it’s getting old.

Now that Dr. Jodi Kuhn purchased her clinics again and seems to have continued with business as usual in Colorado. Another turd has been thrown in the CSHM punchbowl by “owner dentist” Dr. James Mann in Reno, Nevada.  Dr. Mann was hired in October 2, 2006 and I’m positive he can be located as an employee of one of CSHM entities if someone looked.

 Dr. Mann filed suit against CSHM in May 2014.  The case was filed in Second Judicial District Court of the State of Nevada-Washoe County.  In like fashion, CSHM has filed a Complaint against Dr. Mann and Small Smiles Reno and asked for a Temporary Restraining Order. This was filed filed in Davidson County Tennessee Court on July 22, 2014.

In Dr. Mann’s lawsuit he claims he owns the Small Smiles clinic and is suddenly—after just shy of 8 years of employment—”concerned that CSHM’s heavy-handed control of Small Smiles is violating Nevada’s laws and regulations.”

I find It laughable that Dr. Mann is just now  “concerned”.  The public and government agencies have been concerned since 2004! How does Dr. Mann explain this?image

Mann claims despite all the name changes—FORBA, Church Street Health Management, CSHM, etc.— many of the same key employees have remained as has their illegal business practices.  (Well, of course, thorn is a thorn by any other name.)

Mann says, “CHSM has continued Church Street’s practices” and “Indeed, many of the personnel associated with Church Street continued to work for CSHM

He claims:

  • Dictated the hours that Dr. Mann and Small Smiles should be open for business.
  • Imposed pressure on Dr. Mann and Small Smiles to schedule more patients.
  • Decided which equipment Dr. Mann could purchase for Small Smiles
  • Insisted on certain dental procedures over others
  • Set. Dr. Mann’s compensation.

Here is a statement that raises HUGE red flags and give me great concern:

Thursday, May 15, 2014

CSHM-Small Smiles Dental v. Jodi Kuhn: Kuhn Responds to Complaint

The Hearing scheduled for May 14, 2014 to hear arguments on the Temporary Restraining Order and Injunction was rescheduled until after June 5, 2014 apparently to allow time for discovery such as a deposition of Jodi Kuhn. (see Joint Motion to Reschedule)

(Waist high boots will not be nearly high enough; so I’m thinking a full diving getup will be needed.)

May 6, 2014 Kuhn filed her Response to CSHM’s Complaint, which I thought odd. Usually at least 2 extensions are asked for before those are ever filed.

Reading the Response will make your head spin, but don’t be alarmed. It’s suppose to make the judge’s head spin, and frankly after reading the Complaint and the Response my sympathy is with any judge who finds this mess on his docket.

I find the Complaint and Response something conjured up in a witch’s cauldron. Hardly a sentence in either has the actual truth of the matter at hand. I wonder how she squares up everything in her Response with the clinics she has her name slapped all over in Ohio and Kentucky. (you will see what I mean when you read it) .

If Kuhn’s lies hold, then every clinic is up for grabs in more than just Small Smiles!

She goes into great depth about how CSHM was the one Excluded from Medicaid and not her Colorado clinics. She even attaches the Joint Report by Senators Baucus and Grassley, talking about what terrible treatment children receive at Small Smiles clinics.

Since she contends HHS-OIG has serious problems with CSHM, and not Small Smiles clinics, I wonder why the clinics, staff and treatment received at the clinics were under such scrutiny; CSHM wasn’t treating these sweet children.

Anyone think HHS-OIG had problems with the way Kuhn’s paycheck was being printed or something? Further she didn’t mind one bit to hand over every dime “her” clinics made to CSHM until the Exclusion was announced.

Frankly, I would have been pissed long before now they were taking all the money I was making straight out of my bank account. Plus, I’d be pissed they were still taking it out of my Ohio and Kentucky clinics. She doesn’t mention those clinics. Hmmm…. 

Doc 24 CSHM v Kuhn Response

Related Documents:

CSHM v Jodi Kuhn Complaint, April 21, 2014
CSHM v Jodi Kuhn Response, May 6, 2014
Thornton Small Smiles Purchase Agreement, May 6, 2014
Thornton Small Smiles Stock Pledge Agreement, May 6, 2014
Joint Motion To Reschedule TRO Hearing, May 12, 2014

Monday, April 28, 2014

Pop the corn, it’s show time! Let the battle of true ownership begin: CSHM sues one of their “owner dentists”

CSHM, LLC/Small Smiles Dental Centers/”fill in the blank” Youth Dental Center” was granted a Temporary Restraining Order against one of its fake “owner dentists” in US District Court last week.(April 25, 2014) The Order was granted after a Complaint was filed against Dr. Jodi Kuhn for allegedly breaching her various Management Service Agreements (MSA’s) with CSHM, LLC.

The Complaint states in January 2013 Dr. Jodi Kuhn Kuhn purchased 4 clinics in Colorado for $100 each from Randall W. Ellis, DDS—the prior fake owner dentist. Ellis purchased from Robert Andrus, DDS, the prior prior fake owner.

(That’s a damn good deal! But I don’t believe it to be true; not much of of anything in these documents is actually true. Kuhn’s name doesn’t’ appear until December 2013. If she purchased the clinics in January 2013, why is CSHM’s Linda Zoeller name still plaster all over the 2013 annual reports. After all Jodi did it herself in December of 2013.)

Thursday, April 17, 2014

How do the folks at Small Smiles-CSHM keep it all straight? A Rant.

How the people at CSHM keep it straight as to when they own the Small Smiles clinics and when they don’t is beyond me; since it always depends on who they are communicating as to whether they own them or not. Of course, the truth is they do own them, and Sen. Grassley’s report provided that evidence.

Church Street Health Management (CSHM) f/k/a FORBA had to divest in the Manassa, Virginia clinic in March of 2012. HHS-OIG sent them a Notice to Exclude. Here is the HHS-OIG agreement sent to Sheila Sawyer, General Counsel and Chief Administrative Officer of CSHM at the time.

On April 30, 2012, the sham owner of the Small Smiles of Manassas, Gillian Robinson-Warner supposedly signed a Termination Agreement with CSHM. The Termination Agreement states Small Smiles of Manassas, LLC, a Virginia limited liability company, “owns and operates a dental practice in a dental office at 9012 Mathis Avenue, Manassas, Virginia 20110”. Apparently the Manassas clinic was the worst of the worst of the Small Smiles clinics. However, all clinics have been under a Quality of Care Corporate Integrity Agreement since January 2010.

As the Manassas Termination Agreement reads one would assume Small Smiles of Manassas, LLC is a living breathing human-being. Gillian Robinson-Warner signed as President of Small Smiles of Manassas, LLC and agreed to pay CSHM $80,000 to CSHM if they would terminate the said MSA.

The very next day—May 1, 2012—two Motions were filed seeking the Bankruptcy Court’s approval to terminate the contracts.

Motions? Contracts? More than one, you ask? 

Yes, there were two!

The same day the Manassas Motion was filed in Tennessee Bankruptcy Court, so was a Motion seeking the courts approval to terminate the Management Services Agreement between CSHM and the Pueblo clinic. The Pueblo clinic is the flagship clinic of the DeRose-Padula family; the ones who created this monster. Isn’t that odd? The Pueblo clinic agreed to pay CSHM $300,000 to terminate their imaginary agreement. Dr. Randall W. Ellis supposed signed as president of the Pueblo clinic.

We know, the Small Smiles of Manassas, LLC is just a shell corporation, like all the others; each clinic has its own LLC or PC designation. Each controlled and operated by the people at CSHM and backers. Those are facts that have been proven over and over.

Despite that being common knowledge; CSHM will tell you the grass is purple while you are standing there looking at it and know its green; maybe they have lived in the fantasy world of “we only provide support services to dentist owned dental clinics land” for so long, they believe their own BS.

It is understandable where all of this might lead to an identity crisis for anyone working at CSHM or any of their Small Smiles clinics; particularly troublesome for Linda Zoeller. She isn’t even sure of her title at the various, LLC’s or PC’s. Here are 4 different titles she gave herself at just one of the Indiana clinics. Stop laughing!


Reading over both Motions and Termination Agreements, I had to laugh out loud a couple of times. (Ok, I’ll be honest, it was more than a couple, and it was more like a couple in “I’ve only had a couple of drinks” kind of way.)

Besides all the stated facts in the document being anything but factual, I had to laugh at the language.

More than once “abundance of caution” was used. By my very favorite was “The Termination Agreement reflects the product of extensive arm’s length negotiations”. I’ll admit I blew coffee across the room when I read that one. I don’t know how a PC or LLC verbalizes its intent in negotiations; sign language?

Thursday, April 03, 2014

CSHM and Small Smiles Dental Centers sign Exclusion Agreement

OIG Excludes Pediatric Dental Management Chain From Participation in Federal Health Care Programs

April 3, 2014

CaptureRelated Information

CSHM, LLC Exclusion Agreement

CSHM, LLC, formerly known as FORBA Holdings and Church Street Health Management (CSHM), signed an Exclusion Agreement that bars CSHM from participating in Medicare, Medicaid, and all other Federal health care programs for a period of 5 years, Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services, announced today. The exclusion is based on CSHM's alleged material breaches of its Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG). CSHM manages and operates the national chain of Small Smiles Dental Centers, which provides services primarily to children on Medicaid. CSHM's corporate predecessor entered into the CIA in 2010, as part of the resolution of a False Claims Act case involving allegations that the company had provided dental services to children on Medicaid that were medically unnecessary or failed to meet professionally recognized standards of care.

To minimize immediate disruption of care to the hundreds of thousands of children treated at CSHM clinics and to enable an orderly, controlled shutdown of the company or divestiture of its assets, the exclusion will be effective on September 30, 2014. CSHM waived its right to appeal this exclusion in any judicial forum.

"CSHM has committed repeated and flagrant violations of its obligations under the CIA—violations that put quality of care and young patients' health and safety at risk," said Inspector General Levinson. "This exclusion underscores our commitment to enforcing our integrity agreements designed to promote quality of care and protect patients in Federal health care programs." Mr. Levinson said that this exclusion "makes clear to the provider community that OIG closely monitors our CIAs, critically evaluates providers' representations and certifications, and will pursue exclusion actions against providers that fail to abide by their integrity agreement obligations."

On March 7, 2014, OIG issued a Notice of Exclusion to CSHM based upon numerous material breaches of its obligations under the CIA. CSHM failed to report serious quality-of-care reportable events, take corrective action, or make appropriate notifications of those events to the State dental boards as required by the CIA, OIG found. CSHM also failed to implement and maintain key quality-related policies and procedures, comply with internal quality and compliance review requirements, properly maintain a log of compliance disclosures, and perform training as required by the CIA. Finally, CSHM submitted a false certification from its Compliance Officer regarding its compliance with CIA obligations.

This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.

The Inspector General credited Special Agents from OIG's Office of Investigations, Miami Regional and Nashville Field Offices, with assisting in this investigation. OIG was represented in the investigation and litigation of this matter by Senior Counsel Felicia E. Heimer, Maame A. Gyamfi, Robert M. Penezic, and Tamara T. Forys, with assistance from Paralegal Mariel Filtz.

CSHM disputed OIG's determination that it was in material breach of the CIA.

Thursday, March 27, 2014

HHS-OIG Report - Questionable Billing For Medicaid Pediatric Dental Services in New York–March 2014

This same study could be done in any state these private equity owned dental clinics operate and the results would be the same, if not worse. All of this has been reported right here since 2007, it’s 2014! Just saying…


Questionable Billing For Medicaid Pediatric Dental Services in New York - March 2014

DSO-PE graphic

Friday, March 14, 2014

Oh where, oh where did it go: CSHM’s Press Release

If anyone is looking for CSHM and Small Smiles press release after the media exposed the fact they will be excluded from Medicaid in 30 days, you won’t find it on their website any longer. No need to put out an “All Points Bulletin”, it can be found below.

President and CEO David R. Wilson, released a memo to payors on March 12, it has since disappeared from their website as well. But never fear,it’s still here.

The whole media statement, from start to finish, basically gave the finger to HHS-OIG and every person who has investigated them since 2007; in addition to making highly misleading—if not down right lying—to staff and employees.

Seems their Facebook page has disappeared as well. I imagine they don’t want any comments or questions, don’t you?

Below is the press release.


March 11, 2014


In a letter dated March 7, 2014, CSHM, LLC (“CSHM”) received a notice of exclusion from federal health care programs from the Office of Inspector General of the Department of Health and Human Services (OIG). The notice of exclusion does not apply to any individual employee or the Dental Centers and Practice Owners, but to the CSHM, LLC corporate entity only. If the exclusion should go into effect, it means that CSHM may not continue with some or all of its current responsibilities under its Management Service Agreement (MSA) and this may affect administrative services related to Center operations.

The exclusion notice is based on the OIG’s determination that CSHM has violated some terms of the Corporate Integrity Agreement (CIA) that has been in place for the management company and its predecessors since January 2010. CSHM assumed the CIA in June 2012 and it is well known that it has implemented the CIA provisions within the Centers and generally since that time. Many Center owners and employees have met the Independent Quality Monitor (IQM) and CSHM’s compliance staff over the last 18 months as the company was implementing the CIA’s provisions. Generally, the alleged violations related to certain delayed reporting of a few adverse clinical events, failure to undertake certain training in 2012 before CSHM assumed the CIA, and the omission of two adverse events on the CIA disclosure log, though over 1,200 events were successfully place on the disclosure log for processing.

CSHM believes strongly that it has substantially and in good faith implemented the CIA at a great cost in resources and with the important cooperation of the Centers and its health care professionals, particularly on the enhancing dental clinical standards. The OIG’s proposed determination to exclude CSHM for some non-compliance with its CIA is an unduly harsh and an unprecedented response to expected and common difficulties in implementing a very complex CIA that has a novel and innovative administrative, process and clinical requirements.

CSHM intends to appeal the notice of exclusion and file a request for hearing with the Department Appeals Board. During the appeals process, the exclusion will be stayed and we will continue to provide business, administrative and support services to 53 associated dental centers in 19 states and the District of Columbia, pursuant to our management services agreements. The legal process will take an indeterminate period of time. In the interim, CSHM will continue to perform normal operations and will continue to provide our internal and external constituents with up-to-date information. Should you have questions regarding this matter, please contact a member of our communications team at Lovell Communications:


Thursday, March 13, 2014

NBC — Firm That Manages Dental Clinics for Kids Excluded From Medicaid



By Talesha Reynolds

    MARCH 12, 2014 - A company that manages a chain of dental clinics once accused of subjecting children to painful and unnecessary procedures and bilking the government for millions of dollars has been notified it will no longer be eligible for reimbursement from federal health care programs like Medicaid, its principal source of revenue.

    The company, CSHM, manages 53 clinics nationwide, most of which operate under the name Small Smiles. The clinics treat mostly low-income children in areas where access to dental care is limited.

    The Office of the Inspector General of the Department Health and Human Services sent a letter to CSHM on Friday citing multiple breaches to a compliance agreement, which mandates quality of care measures. The breaches included failing to report incidents involving patients at Small Smiles clinics in Tulsa, Okla., and Mattapan, Mass.

    The OIG declined to provide further detail on the specific breaches that led to the exclusion.

    Sen. Chuck Grassley, R-Iowa, who last year published a report on corporate dental management companies along with former Sen. Max Baucus, D-Mont., said Monday that the CSHM exclusion notice “will protect both taxpayers and vulnerable children receiving dental care in the Medicaid program.”

    Read the entire article here


    Dental chain accused of hurting kids, bilking taxpayers December 11, 2012

    Monday, March 10, 2014

    FINALLY! Small Smiles Dental Centers are EXCLUDED from Medicaid and other Federal health programs!

    OMG! OMG! OMG!

    After 7 long years of persistence, it’s finally happened! Small Smiles Dental Centers are excluded from participation in Medicare, Medicaid and all Federal Health Care Programs!

    Small Smiles Dental Centers - CSHM Exclusion Letter by Dentist The Menace

    Let us not forget, the dental centers Quality and Compliance was overseen by:

    Dr. Paul Casamassimo
    Dr. Arthur Nowak
    Dr. Joe Bernat
    Dr. Anupama Tate
    Dr. Steve Adair

    Quality & Compliance - Dental Centers - CSHM by Dentist The Menace


    I can’t woo hoo and OMG enough—I’m shaking from head to toe with glee!!!!!

    Now, where can I locate a bottle of the “good stuff” Champaign!

    Monday, December 16, 2013

    The Medicaid gravy train continues

    If you read this blog, then you know profits with Medicaid dentistry is made on high volume, gross excessive treatment, all at a single visit. The prime example is Small Smiles and their Production Per Patient (PPP) mantra handed out to their employed dentists. As testimony revealed in a New York malpractice case, "PPP is the Golden Goose", said one Small Smile executive. As was put another way by one of Small Smiles managers, “you eat what you kill”. 

    It’s undeniable, years ago, Small Smiles Dental set the gold standard of excessive treatment by restraining children with use of the papoose board. 

    As heat from press, parents and few state dental board followed some Medicaid accepting dentists and dental chains decided sedation would be the key even more profits, leaving the least amount of yuk in everyone's mouth—the children, the parents and especially the public.

    Weekend "get-a-way" sedation courses were developed, lobbyist hired and representatives of the dental community were sent on press junkets stressing the need for higher reimbursements from insurers and Medicaid; all to accomplish the same thing—Production Per Patient. Now, as ABC news has reported in 2012, we have children being overdosed, brain damaged and dying at an alarming rate.

    All the while, government regulators appear to be hiding under their desks. It is understandable that the bulk of the dental profession has given up. It’s been proven over and over there is no money to be made in Medicaid dentistry, if provided ethically. Add government corruption and ineptitude to the mix and it’s like the sadistic relationship between the addict, and their co-dependent enabler; life and death danger to both.

    Wednesday, October 23, 2013

    Is CSHM, LLC taking full responsibility for all future legal actions against Small Smiles Dental Centers? You decide.

    Update: 10-24-2013 10:58AM

    On October 9, 2013 the so-called “new company” who owns and operates all the Small Smiles Dental Centers that have managed to remain open denounced its association with the so-called former owners and management company.  (see statement below)


    In making this claim, they must also be taking full responsibility for any and all illegal activities and/or malpractice issues that could arise in the future, right?  As the below email suggests, those will be coming.

    Hi - I have kept up with your site for a while now because honestly it was the only way to find out the "real" news on Small Smiles. I am former employee of Small Smiles in South Carolina. When I took the position I had NO clue what I was getting into. I resigned from my position due to the horrible reputation Small Smiles has and it was mentally exhausting to even go to work.

    Thursday, August 15, 2013

    Small Smiles Dental Centers’ last ditch effort to avoid trial has FAILED

    After 2 years or more of stall tactics by attorney’s representing Small Smiles Dental Center defendants, the New York trials are set to begin in three weeks!  Yes, you heard me, three, count’em 1… 2,…3… weeks!  Yahoo!  Jury selection set to begin September 9, 2013.

    Tuesday (August 14, 2013) the  court ruled against Small Smiles and defendants and their plea for a Summary Judgment — essentially telling the old boys to buckle-up, quit whining, they have you by the balls, be ready for trial or start writing checks. Small Smiles Dental Centers’ former dentists (17 in total) and that nasty DeRose crew in Colorado are in for a very bumpy ride. 

    Small Smiles Dental Centers NY Malpractice Defendants are:



    FORBA Holdings, LLC

    Dan E. DeRose
    n/k/a Church Street Health Management, LLC Michael A. DeRose


    Edward J. DeRose


    Adolph Padula

    DD Marketing, Inc.

    William A. Mueller

    DeRose Management, LLC

    Michael Roumph

    Small Smiles Dentistry of Albany, LLC

    Maziar Izadi, DDS

    Albany Access Dentistry, PLLC

    Laura Kroner, DDS

    Small Smiles Dentistry of Syracuse, LLC

    Judith Mori, DDS


    Lissett Bernal, DDS
    Edmise Forstal, DDS
    Evan Goldstein, DDS
    Keerthi Golla, DDS
    Nassef Lancen, DDS
    Wadia Hanna, DDS
    Koury Bonds, DDS
    Tarek Elsafty, DDS
    Dimitri Filostrat, DDS
    Yaqobb Khan, DDS
    Delia Morales, DDS
    Janine Randazzo, DDS
    Loc Vin Nuu, DDS
    Grace Yaghmai, DDS
      and others
    These sweet children were hurt and abused and forevermore changed from as far back as 2006, and it’s finally making it to trial!  So, as a warning to all you dentists still employed there, don’t think your ass is out of a bind when you quit; cause it “ain’t”.  Not by a long shot!

    Some of the dentists say the used their best medical judgment to provide dental care to the children suing them, but evidence indicates that isn’t even close.  In fact, it’s laughable! Evidence provided showed Koury Bonds, DDS and the others violated the “relevant standard on care” on several issues. 

    According to the ruling, there is plenty of evidence these dentists prepared and recommend treatment without clinical justification and performed substandard care. 

    They unnecessarily restrained children in papoose boards; extracted teeth that without clinical justification; failed to use local anesthetics, filled teeth that didn’t need to be filled; altering records; performing unnecessary baby root canals;(remember that $35 million dollar award a few weeks ago over unnecessary root canals?) failed to obtain proper informed consent for treatment from parents; just to name a few.  These guys knowingly and purposefully used informed consent forms that they knew did not meet the standards or guidelines of the American Academy of Pediatric Dentistry (AAPD).

    Now, haven’t I been screaming this as loud as I can for some 6 years now.  Everything I’ve uncovered and reported here about this horrible place is being proven to be the truth, and it looks like it’s going to be told in front of a jury, pretty damn quickly.

    In the ruling the Judge states, “There…is ample evidence from which a jury could concluded that the defendants perpetuated a fraud on the plaintiff by treatment him and other Small Smiles patients not to meet his medical needs but as a means to maximize profits for the dentists, corporations and Individual Defendants.” (the DeRose crew)

    More excerpts from the ruling:

    “Email correspondence… demonstrates the overriding emphasis on profits.”  One such email between Michael Roumph and the lead dentists in the Albany NY clinic states “[p]roduction per patient needs to improve.”