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

Related:

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

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.

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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.

How many lawsuits have been filed against Small Smiles Dental Centers and the dentists who have worked there?

March 4, 2013
The answer can be found in court documents filed during their bankruptcy proceedings over the last year.  According to Affidavit of Chief Restructuring Officer of Martin McGahan, 100 were on file in February 2012.  More recent documents filed by their malpractice insurance carrier states 1100 are "working” so to speak and more lawsuit likely to come.

 

Affidavit of Martin McGahan - Doc 11 - February 20, 2012 – page 14 paragraph 38

“Since January 2010, approximately 11 lawsuits on behalf of over one hundred plaintiffs have been filed against the Company and certain of the Dental Centers, in primarily three states, Ohio, New York and Oklahoma.”

NUFI Objection Doc 568 - December 28, 2012 – page 4 paragraph 3:

“Subsequent to the Debtors’ settlement with the DOJ and the various states, a number of lawsuits were filed throughout the country by or on behalf of the Dental Center patients against certain of the Debtors, Dental Centers and Dentists, alleging claims for damages based upon treatment received at the Dental Centers. In addition to the Patient Litigation, the Debtors contend that “at least approximately 1100 additional patients or former patients” have retained counsel to assert similar claims against the Debtors, the Dental Centers and the Dentists.”

Dentists and auxiliary employee of Small Smiles Dental Centers (current or former) are not likely to be able to exhale for a very long time.

For a list of the 600 plus pleadings and filing of this case see in United States Bankruptcy Court – Middle District of Tennessee, see:
Church Street Health Management Docket Report

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In other Small Smiles Dental Centers news.  I’m told the morning huddles continue and production numbers remain a major topic of discussion. 

Small Smiles Dental Centers Bankruptcy–It’s complicated

It’s complicated to liquidate a company operating illegal dental clinics.  As of February 21,2013 there have been 630 various pleadings filed in the bankruptcy case of Small Smiles Dental Centers. The Docket report is dang near 70 pages.  Even it is an interesting read.

If you currently work for Small Smiles Dental Centers or have EVER worked for Small Smiles Dental Centers you need to read this carefully. I realized they mass mailed a “Summary” of the Liquidation and Trust Agreement, as well as a “Ballot” but the key word is “summary”. 

This junk company is an albatross that will forever more hang around the neck of every executive, every regional or sub-regional manager and every dentist who ever worked there. You will constantly be looking over your shoulder for the next 10 years or longer. 

The last time I took the bar exam was…  uh… NEVER, so read it and draw your own conclusions.  

This the the current PROPOSED Plan of Reorganization and not approved by any means as of yet.  There are objections by their malpractice carrier on file, and that’s where the dentists come into play even more I suspect.

[Now, if I found myself in the middle of a malpractice lawsuit and being represented by an attorney assigned to me by a malpractice insurance company who didn’t want to cover claims because they got hoodwinked by some slick willy system scammers, I’m not sure I’d feel that particular attorney had my best interest in mind.  Think about it.]

Proposed Second Amended Joint Plan of Reorganization Doc 594 01-11-2013

I particularly enjoyed this section on page 17.

4.17(h) Claims Against Former Affiliates. Each holder of a Class 5(a) Claim will retain any and all claims and legal rights such holder may have against any of Danny DeRose, Edward DeRose, Michael DeRose, William Mueller, or Adolph Padula. All holder of Class 5(a) Claims will be entitled to initiate and prosecute any such claim against any or all of Danny DeRose, Edward DeRose, Michael DeRose, William Mueller, or Adolph Padula without restriction in the tort system. To the extent the automatic stay in these Chapter 11 Cases or any other limitation imposed by these Chapter 11 Cases would limit any such action, such automatic stay or limitation will be lifted thirty (30) days after the Effective Date of the Plan

Summary of Liquidation and Trust Agreement

Church Street Health Management Court Docket, February 21,2013

Oh where, oh where has Small Smiles gone, oh where, oh where can it be…

February is “National Children’s Oral Health Month”. Normally Small Smiles Dental Centers lead dentists (or fake owner dentists) slither from under their rock and hit local morning TV talk shows, claiming they are having free services that very morning for a couple of hours. So far, I’ve not seen hide nor hair of them in 2013. Kool Smiles Dental centers at least announced they gave away toothbrushes this year. (Geez, I hope they weren’t those chemical-laden ones from China that leave blisters in your mouth.)

Small Smiles “free services day” were a sneaky ploy. The dentists would appear on local talk shows about 6 AM announcing they were having free services that morning; from 9AM-11AM for example. They would invite the public, telling them they needed to call for an appointment; failing to mentioning the schedule was already packed tight as sardines – as they were everyday.

It was last year about this time they were preparing documents to file bankruptcy in Nashville’s Federal Court and closing several clinics (updates on that coming soon). By June the OIG forced them to divest in at least one clinic; personally I think it was more than one, Manassas, Virginia clinic for sure. (Let’s just say, whoever took over Manassas, also took the Pueblo, Colorado clinic as well. See: Violations of Corporate Integrity Agreement Triggers Divestiture Action by HHS OIG.

“It is clear that the defendants’ actions constituted more than just malpractice.” –Judge John Cherundo, Onondaga County Superior Court

By August 2012, Small Smiles Dental Centers were taking serious hits in the malpractice cases file against them. In 2011, families of at least 75 children had filed lawsuits in New York against the Small Smiles Dental Centers. Judge John C. Cherundo denied the companies request to dismiss the cases saying, “This intentional misconduct was part of the of the alleged scheme to generate revenue as quickly as possible”. 

Morally Bankrupt Carlyle Group Continues with Bankrupt Theme

From PEU Report

Carlyle's Latest Bankruptcy: Medicaid Dental for Kids

The Tennessean reported: A Nashville-based company that manages dental care centers in 22 states has filed for bankruptcy to restructure its debt and eventually attempt to sell its operations and assets.

Church Street Health Management LLC’s filing with the Middle Tennessee U.S. Bankruptcy Court this week listed roughly $85 million of assets and $300 million of liabilities.

How much goodwill did it take to get Church Street's sheet to balance?  Owners not only stretched the value of the company, they took liberties with kid's teeth and billing Uncle Sam.

That debt includes $150 million owed to its lenders and $17 million owed to several states and the U.S. Department of Justice under a settlement of charges that it billed Medicaid for unnecessary dental procedures for low-income children.

The settlement period runs from September 2006 to January 2010, all years under PEU ownership. Church Street's sins include:

(1) causing claims to be submitted by the Centers for reimbursement for performing pulpotomies that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care

(2) causing claims to be submitted by the Centers for reimbursement for placing crowns that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care

(3) causing claims to be submitted by the Centers for reimbursement for the administration of anesthesia (including, without limitation,nitrous oxide) that was not medically necessary, that was performed in a manner that did not meet professionally-recognized standards of care, and/or was administered by an unlicensed, non-certified, or otherwise unauthorized individual

(4) causing claims to be submitted by the Centers for reimbursement for extractions that were not medically necessary and/or were performed in a manner that did not meet professionally recognized standards of care

(5) causing the Centers to fail to obtain informed consent for certain dental procedures and services

(6) causing claims to be submitted by the Centers for reimbursement for fillings that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care

(7) causing claims to be submitted by the Centers for reimbursement for sealants that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care

(8)causing claims to be submitted by the Centers for reimbursement for radiographs (i.e., x-rays) that were not medically necessary, were taken in a manner that did not meet professionally recognized standards of care, and/or were taken by an unlicensed, non-certified, or otherwise unauthorized individual

(9) causing claims to be submitted by the Centers for reimbursement for behavior management techniques, including without limitation those techniques involving a papoose board, that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care.

The above behavior resulted in a $24 million (plus interest) fine.  It seems Carlyle and Church Street are morally bankrupt as well as literally.

Did Church Street pay dividends or special distributions since The Carlyle Group invested in the company in September 2006? 

 If so, did PEU owners load Church Street with debt to fund payouts?

Medicaid considers management fees and capital cost reimbursable items on the acute side of health care.  Does it do the same for dental? 

How much did Carlyle, American Capital Strategies and Arcapita pull out of Church Street before it imploded? 

[A LOT!]

Did any buy credit default swaps on Church's debt? That could help ease the ache, but it would continue the morally bankrupt theme.

Private equity purports to be the savior of America's lopsided health care system.  Greed won't help, not in the least.

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Arcapita(f/d/b/a First Islamic Bank), another principal part of the terrorizing company, also filed bankruptcy.

Below are Statements and Reports of Church Street Health Management – Small Smiles filed with the Bankruptcy Court. You don’t want to miss these.

• March Monthly Operating Report
• Statement of Financial Affairs for Small Smiles Holding, LLC
• Statement of Financial Affairs for Church Street Health Management, LLC
• Statement of Financial Affairs for EEHC, LLC (the executives and directors arm of Small Smiles dental centers)
• Statement of Financial Affairs for FORBA NY, LLC
• Statement of Financial Affairs for FORBA Services, LLC