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:

Companies	Individuals
FORBA Holdings, LLC	Dan E. DeRose
n/k/a Church Street Health Management, LLC	Michael A. DeRose
FORBA NY, LLC	Edward J. DeRose
FORBA, LLC n/k/a LICSAC, NY, LLC	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.” 

Church Street Health Management, LLC Managers

Taken from the 2010 Annual Report to the Kentucky Secretary of State:
Rodney Cawood – 618 Church Street Suite 520, Nashville, TN  37219
Jack Draughon –2928 Habersham Road, Atlanta, Georgia 30305
Charles Griffith – 4209 South Bellaire Circle, Englewood, Colorado 80113
Charles H. Ogburn – 3807 Vermont Road, Atlanta, Georgia 30319
Bowen Diehl – 2945 Stanford Avenue, Dallas Texas 75225"
Michael Lindley – 857 Curtiswood Lane, Nashville, TN  37204
Alford J. Smith – 1652 Jacobs Drive, Gallatin, TN  37066
Scott A. Buschmann – 75 14th Street 24th Floor, Atlanta, Georgia 30309

Michael Lindley still referred to being employed with Keys Group in 2007 and 2008 & US v Keystone Education and Youth Services

US v Keystone et al accused the M. Lindley and Al Smith group of characters of restraining children, and more Medicaid Fraud.  Appears to be a lifestyle for these folks.
US v Keystone Education and Youth Services; Keystone Marion, LLC; Universal Health Services,
Currently a Subsidiary of Universal Health Services (UHS), UHS was not named as a defendant in all the allegations of the suit, because; “UHS indirectly acquired the other two defendants in or around October 2005; accordingly, UHS is not included in “Defendant” for allegations to the extent that they are related to the events occurring prior to that time.” (page 3, paragraph 10)
UHS acquired the group of Keys companies in October 2005, from Michael Lindley (“Lindley”), Marty Weber, Ameris Healthcare Investments, LLC, Rainer Twiford, Al Smith (“Smith”), Mike White, Rodney Cawood (“Cawood”), Buddy Turner, Jeff Cross, Gail Debiec, Brad Gardner, Brad Williams, Don Wert, Rob Minor, Mike McCulla, Jim Shaheen, Rod Gaeta.  See purchase agreement here.
If the jokers actually “sold” the company,  I can’t imagine why Michael Lindley would contribute to Alexander for Sentate in 2008, twice saying his occupation was Keys Group Holdings.  One contribution was April 19, 2007 for $2300 and again February 27, 2008 for another $2300.  My guess it was really “recapitalization of income” instead of a sale.
Just as in the Small Smiles Dental Centers scam, Keystone’s facilities.. “With only a few exceptions, Defendant restricted admission to the Youth Center to patients who would qualify for reimbursement of the medical costs under the Medicaid program”  (page 3, paragraph 13)
Related:
Federal, state prosecutors join suit against Keystone Marion Youth Center- March 5, 2010

Justice Department asked to investigate Chad Youth Enhancement Center – January 29, 2008

Nashville Scene “Handle With Care” expose’ by Elizabeth Ulrich- November 8, 2007 (the same week the story of the Small Smiles Dental Centers operated by Michael Lindley, Al Smith and others was announced.  That must have been a bad week for them.

Bad Medicine –December 13, 2007- A Nashville youth facility is a nightmare for kids, staffers say, but the state’s licensing body sees no cause for concern, by Elizabeth Ulrich.

Excerpt: ”Checo Perryman, a former counselor at the facility who now runs his own business that teaches an alternative method to Handle With Care, says it was so common for Hermitage boys to smack their chins on the floor during restraints that the facility’s staff named the bloody scabs on the boys’ busted chins. They called it the “Hermitage Hall tattoo.
“What happened behind those walls was very scary and very sad,” he says. But not all restraints end in injury. For some residents, restraint leads to a drug-induced haze that eventually lulls them to sleep—or, as some in the mental health world refer to it, chemical restraint, quite simply because the drugs can be used to restrict residents deemed out of control.
Among incident reports in the DMHDD files, there is tale after tale of restraints that end in some sort of injection. Some of the medications are listed by name—Abilify or Zyprexa, drugs that are used to treat schizophrenia and severe mood disorders. In most of the records, staffers refer to injections with a simple, generic term: PRN, short for a Latin phrase meaning to give drugs as needed.
Davis says that, for Hermitage Hall residents, those unidentified PRN shots usually mean a syringe full of Thorazine—one of the most powerful antipsychotic drugs, which critics liken to a chemical straitjacket.
Even though Hermitage Hall doesn’t always include the name of the drugs administered under the PRN umbrella, Robinson-Coffee says the injections aren’t cause for concern. She says her department could check any of the estimated 100 patient records at Hermitage where “all that stuff is documented.”

Guess who operates Hermitage Hall.

Mike McCulla–Another Nashville creep working along side Michael Lindley and Al Smith - for a long time now.

Mike McCulla – Marketing for Church Street Health Management LinkedIn - http://www.linkedin.com/pub/mike-mcculla/1a/4a0/521
LinkedIn profile used to say he is/was Marketing at Children’s Comprehensive Services.  He’s dropped that and added Universal Health Services.
He’s been with Michael G. Lindley, Al Smith and others for a long time.  Even as far back as when CCS went under the name Pricor.
Mike McCulla, Michael J. Lindley , Al Smith, Rodney Cawood, and Brad Gardner together with others were owners of Pricor.  So this nastiness of treating children badly is nothing new to these creeps.  They have made a very nice living doing it.  Somehow you can find trotting around Nashville with their heads up, and not hanging in shame.  I don’t know how, but they do it, daily.
Purchase Agreement for Keys and CCS – the above named creeps are named as the sellers.  A year later they are abusing children again through their Small Smiles Dental Centers.  Snakes in the grass, no doubt.
Pricor History – It was not a nice company; Texas had real issues with the company.
Type: Public Company
Address: 3401 West End Ave., Ste. 400, Nashville, Tennessee 37203, U.S.A.
Telephone: (615) 250-0000
Fax: (615) 250-1000
Web was: http://www.ccskids.com
Employees: 3,000
Sales: $126.77 million (2000)
Stock Exchanges: NASDAQ
Ticker Symbol: KIDS
Incorporated: 1985
NAIC: 623990 Other Residential Care Facilities; 624110 Child
SIC: 8361 Residential Care; 8211 Elementary & Secondary Schools; 9223 Correctional Institutions
Children's Comprehensive Services, Inc. (CCS) based in Nashville, Tennessee, is one of the nation's leading providers of educational services, psychiatric treatment, and juvenile corrections for at-risk children and juveniles in the United States. Operating in 14 states and serving over 3,700 children and their families, CCS staffs both residential and day treatment facilities that provide services ranging from special education for autistic and developmentally delayed children to more intensive boot-camp programs set up to rehabilitate juvenile offenders. CCS has contracts with both governmental and non-governmental nonprofit agencies in Alabama, Arkansas, California, Florida, Hawaii, Kentucky, Louisiana, Michigan, Montana, North Carolina, Ohio, Pennsylvania, Tennessee, and Utah.
The contemporary privatization of government correctional facilities seemed to have been born out of the inspiration of several groups of investors from Nashville, Tennessee. Nashville was the birthplace of two of the three earliest and largest pioneering companies in the business--Corrections Corporation of America and Pricor Inc.
Pricor was founded in 1985 in response to a need for more and better run prisons in the United States and the belief that there was money to be made offering smaller municipalities private assistance. Prisons were overcrowded and significant amounts of money were being spent on building and maintaining correctional institutions. Pricor and its investors believed that through privatizing the industry it could successfully manage and correct the flawed system of both adult and juvenile corrections, and turn a profit at the same time.
Originally most of the available contracts for private prison operation were with women's detention centers, immigration holding centers, and juvenile justice placements, but Pricor succeeded in obtaining a contract for staffing and managing a maximum security jail in Greene County, Tennessee, in the late 1980s.
Pricor expanded operations into Alabama and Virginia in 1986, opening minimum security detention centers for a total of 170 inmates. In 1987, Pricor leased two facilities from a hospital system in California, and began its California operation. The state of California and its various municipalities remained one of CCS's largest client populations.
While still hoping to make significant strides with adult corrections, Pricor took what contracts it could get and ended up working closely with juvenile offender populations throughout the 1980s. In 1988 the company acquired Advocate Schools, a company dedicated to the care, education, and treatment of at-risk youth in California. Advocate Schools contracted with school districts based on referrals. Offering both community-based programs in which students attended an Advocate School on a day-to-day basis, and residential schools for students with more intensive needs, the school maintained nine community based sites throughout California. The original site in San Bernardino was established in 1982 with other sites opening throughout the 1990s. Nine residential schools made up the remainder of the Advocate Schools campus, making it the largest nonpublic alternative school system in California.
Advocate Schools was cofounded by Amy Harrison and Martha Petrey, who were retained by Pricor as vice-chairman/president and executive vice-president, respectively. Harrison was also cofounder and executive director of Helicon, a nonprofit group that contracted with CCS in a number of joint ventures.
It was during the Reagan Era, with its tougher prison sentences and stiffer drug conviction penalties, that Pricor made its most ambitious attempt to deal with overcrowded prison conditions in metropolitan counties. Pricor convinced rural county jails to contract with the company and offer their largely empty jails to prisoners from more populous regions for a fee. Pricor teamed up with Houston-based N-Group and first pitched the "jails for hire" plan in west Texas in 1990. The companies convinced municipalities to build new facilities with millions in government bonds and Pricor experienced tremendous initial success, with revenues of over $30 million in fiscal 1991. However, the lucrative payoff to Pricor was mainly in short term up-front fees. Eventually the deal turned sour, with the private prisons remaining empty and therefore unprofitable; for its alleged corporate misdeeds, Pricor was named by a Texas grand jury as an "unindicted co-conspirator" with N-Group. N-Group's penalties were far greater, however, as it was indicted on criminal antitrust charges.
With the Texas dealings now a nightmare, the company found itself losing money in 1992. Facing a tenuous financial future in adult corrections, Pricor exited the business in 1993. Instead, Pricor was increasingly moving forward with its juvenile facilities, and in 1994 the company's board of directors approved a re-direction of the company and an accompanying name change. Pricor was now to be known as Children's Comprehensive Services Inc. (CCS). The company was traded under the symbol KIDS on the NASDAQ. By the end of fiscal 1994, CCS was serving over 1,500 children and their families in Alabama, California, Louisiana, and Tennessee.
Pricor benefited greatly with the passage of The Individuals with Disabilities Education Act (I.D.E.A.). The new federal law mandated that states provide every school-age child with a free and appropriate public education. If a public school was unable to accomplish the mandate through its normal operations, a school district was enabled to refer a student to a nonpublic school able to provide the services required. Pricor and Advocate Schools functioned to provide special needs services to school districts all over the state of California.
In addition to redirecting the company in 1994, CCS also undertook a financial restructuring in an attempt to keep the company solvent. In 1993, Pricor had solicited help from T. Rowe Price Strategic Partners Fund II, L.P. in the form of a one-year $1.5 million term loan. The company was also granted a renewal of a $10 million revolving credit facility through its banks. Pricor was in default on the credit and T. Rowe Price and Pricor settled on approximately one-third of Pricor's outstanding common stock shares at a purchase price of $1.8 million for its having cured its default status and for re-securing the loan.
The second part of the financial restructuring involved converting the company's short-term loans from both its banks and T. Rowe Price into long-term obligations. Pricor, now CCS, had commitments to National Health Investors, Inc. for $6.5 million and T. Rowe Price for $1 million. The local First American Bank of Nashville completed the financial overhaul when it extended a line of credit to CCS for the purposes of supplying working capital to keep CCS afloat. All told, the company was dangerously close to bankruptcy and had it not been for the aid of the financial institutions CCS would have more than likely folded.
CCS provided services in a variety of areas for children and adolescents. Treatment facilities were devoted to rehabilitating youth who were sexually abusive, had substance abuse issues, or needed crisis intervention for all sorts of emotional needs. The special education service centers, including Advocate Schools, concentrated their care on students suffering from a diverse range of special needs, including autism and attention deficit disorders.
Children's Comprehensive Services relied on reimbursement from Medicaid, managed care, and private insurance companies. Day treatment programs provided the greatest financial return to the company, but rates varied according to the contracting parties. Some states cut reimbursement costs, greatly affecting CCS's profit margin and sometimes leading to discontinued services, as in the case of CCS of Montana and the Helicon Youth Center in California.
CCS offered programs to deal with a wide variety of problem areas for the child and juvenile patient. The company tailored its operations to very individualized treatment plans and had centers throughout its 14-state region that met the diverse needs of its target population.
In September 1998, CCS acquired Ameris Health Systems, Inc. Ameris' wholly owned subsidiary American Clinical Schools, Inc. operated treatment facilities for juvenile sex offenders in several states. The following December the company acquired Somerset Inc., a California company that provided educational day treatment to children and their families. The company merged with Ventures Healthcare of Gainesville, Inc. in June 1998, making the year an important one for company growth.
In August 2000 CCS opened the Dallas alternative education program as well as Bristol Youth Academy in Liberty County, Florida. The company also expanded the hospital facility it operated in Ohio.
In October 2000 the company retained McDonald Investments Inc. to assist the company with its financial resources. The company was looking at a possible sale to a competitor. It was undetermined at the time whether the company would be divided up or sold in its entirety. Company leadership was looking to McDonald Investments as well to assist them in their decision making.
In November 2000, CCS closed its long established Helicon Youth Center (HYC) and its related school. Helicon Youth Center had undergone a licensing investigation by Community Care Licensing (CCL), a division of California's Department of Social Services, and CCL had some concerns with the center. A two-year probationary agreement was established between CCL and HYC but in the meantime referrals were no longer made by Riverside County and there was a significant drop-off in the number of clients. The company also experienced a decline in students to its non-residential day treatment programs.
As the company entered the new millennium the outlook for Children's Comprehensive Services was mixed. William Ballard, chairman and CEO, optimistically stated, "We believe CCS's prospects for additional profitable growth are supported by the market's continued strong demand for services for at-risk youth. Our pipeline of potential contracts has expanded because of our reputation for quality, the wide variety of services we offer, and increased interest in our specialty programs such as the gender specific treatment programs." Yet the company appeared unprepared to forge ahead on its own. Indeed, CCS ended fiscal 2001 with an offer of a buyout. The details remained undisclosed, but the potential buyer was described as one of CCS's major competitors.
There was no disputing that mental health issues among youth were now at crisis proportions in the United States and that the juvenile justice system was overcrowded and in need of assistance.
With the rising demand for specialty services among youth, CCS, or whomever was involved in its takeover, appeared to be well positioned to help in the education and treatment of some of the nation's highest at-risk youth. A larger public policy question was whether the country and its municipal governments would be willing to pay the high cost of such services to private companies over the long haul. If government entities believed that CCS could provide quality care at a reasonable cost to the taxpayer the contracts would continue to be signed and CCS and its investors would reap the benefits.
Principal Subsidiaries
Children's Comprehensive Services of California, Inc. d/b/a/ Advocate Schools; CCS/ Altacare of Arkansas, Inc.; CCS/ Bay County, Inc.; CCS/ Gulf Pines, Inc.; CCS/ Lansing, Inc. d/b/a/ Rivendell Center for Behavioral Health; CCS of Montana, Inc.; CCS/ Rivendell of Arkansas, Inc.; CCS/ Rivendell of Kentucky, Inc.; CCS/ Salt Lake City, Inc., d/b/a/ Copper Hills Youth Center; Ventures Healthcare of Gainesville, Inc.; Chad Youth Enhancement Center; CCS/Meadow Pines, Inc.; American Clinical Schools, Inc.; Tennessee Clinical Schools, Inc., d/b/a Hermitage Hall; Alabama Clinical Schools, Inc.; Pennsylvania Clinical Schools, Inc.; Somerset, Inc.; CCS of Hawaii, Inc.
Principal Competitors
Cornell Corrections Inc.; Ramsay Youth Services, Inc.; Res-Care, Inc.
Further Reading
"Children's Comp Could Shop Itself," Mergers & Acquisitions Report, October 16, 2000.
"Children's Comprehensive Services Inc. First Quarter Financial Results, Managed Behavioral Health News, November 23, 2000.
"Children's Comprehensive Services Inc. (in Talks to Sell Firm)," New York Times, June 16, 2001, p. B3.
"County Hears Sales Pitch by Jail Firms," St. Petersburg Times, November 13, 1987, p. 1.
"Education Microcap Chalks Up Possible Buyer ... Perhaps," Mergers & Acquisitions Report, June 25, 2001.
Hodges, Lucy, "Removing the Bars to Private Jails," Daily Telegraph, March 1, 1989, p. 17.
"Hospital to Be Used to House Juveniles," Los Angeles Times, Metro Section, November 25, 1987, p. 11.
McCartney, Leslie, "BU-School-Funds," Montana Standard, April 1, 2001.
Company Perspectives:
CCS, created in 1985, is not just a corporation ... or a leader of educational and treatment services in the country ... or thousands of employees dedicated to making a difference in the life of a child ... CCS is all of these things and more.
CCS is about providing services to thousands of children and adolescents who are not succeeding in their traditional educational, family or everyday life setting. CCS is more than just a business, and it's more than a job. It's about getting up every day and imagining and working on an idea to add to a lesson plan, or finding a special computer software program that will excite and inspire a student who has never succeeded in school. It's about praising a child or youth for all the right things they do. It's about operating a detention center knowing that the CCS exceptional and specialized training will ensure a safe and secure setting for the youth, staff and the community.
Key Dates:

• 1985: Pricor Inc. is founded by a group of Nashville
• 1986: Pricor enters the adult private prison business.
• 1987: Pricor leases two facilities in California.
• 1988: Pricor acquires Advocate Schools, a business dedicated
• 1989: Pricor enters deal in the United Kingdom to staff
• 1990: Pricor pitches "prisons for hire" in rural west Texas.
• 1991: Pricor posts earnings of $30 million.
• 1992: Texas project fails.
• 1993: Pricor exits adult corrections business and focuses on children
• 1994: Pricor changes its name to Children's Comprehensive
• 1999: CCS closes its Helicon Youth Center in Riverside County,
• 2001: Possible buyout of CCS by undisclosed competitor
• 2005: Buyout by Universal Health Services

Preview of the Purchase Agreement
OWNERSHIP INTEREST PURCHASE AGREEMENT
THIS OWNERSHIP INTEREST PURCHASE AGREEMENT (together with all Exhibits, Schedules and other documents and instruments incorporated herein by reference, the “Agreement”) is made and entered into as of the 3rd day of October, 2005, by and among Harbinger Private Equity Fund I, L.L.C., Keystone Group Kids, Inc., Michael Lindley (“Lindley”), Marty Weber, Ameris Healthcare Investments, LLC, Rainer Twiford, Al Smith (“Smith”), Mike White, Rodney Cawood (“Cawood”), Buddy Turner, Jeff Cross, Gail Debiec, Brad Gardner, Brad Williams, Don Wert, Rob Minor, Mike McCulla, Jim Shaheen, Rod Gaeta (each a “Seller” and collectively, the “Sellers”), and Universal Health Services, Inc., a Delaware corporation (“Buyer”).
W I T N E S S E T H:
WHEREAS, Sellers collectively own one-hundred percent of the issued and outstanding ownership interests (“Ownership Interests”) issued by KEYS Group Holdings LLC, a Delaware limited liability company (“Keys”), as of the date hereof; and
WHEREAS, Keystone Education and Youth Services, LLC, a Tennessee limited liability company (“Keystone”), and Children’s Comprehensive Services, Inc., a Tennessee corporation (“Childrens”), are each either a wholly owned limited liability company or corporate subsidiary of Keys; and
WHEREAS, Keystone/CCS Partners LLC, a Delaware limited liability company (“KCP”), is eighty-five percent (85%) owned by Keys and fifteen percent (15%) owned by Childrens; and
WHEREAS, Keystone, Childrens and KCP are sometimes referred individually as a “Keys Sub” and sometimes collectively referred to as the “Keys Subs”; and
WHEREAS, the Keys Subs collectively own one-hundred percent of the ownership interests in the entities listed on Exhibit A hereto (collectively, the “Keys Companies”); and
WHEREAS, the Kids First Foundation (“Foundation”) is a non-profit tax exempt entity whose purpose is to provide education and residential facility services; and
WHEREAS, collectively, Keys, the Keys Subs and the Keys Companies are sometimes referred to as the “Keys Group.” The Keys Group provides group home, behavioral health, juvenile detention, educational, and other treatment related services through its wholly owned and operated facilities set forth on Exhibit B hereto (the “Facilities”); and
WHEREAS, Buyer desires to purchase one hundred percent of the Ownership Interests which will be issued and outstanding immediately prior to the Closing (as defined in Section 3.1 below) and Sellers desire to sell to Buyer the Ownership Interests owned by them and to provide for the sale to Buyer of the additional Ownership Interests to be held by the Option Holders (as defined in Section 2.6 below) immediately prior to the Closing, all on the terms and conditions set forth in this Agreement.

---

NOW, THEREFORE, for and in consideration of the premises, the mutual promises and covenants contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto, intending to be legally bound hereby, agree as follows:
ARTICLE 1
TERMS
1.1 Accounting Terms. Accounting terms used in this Agreement and not otherwise defined herein shall have the meanings attributed to them under GAAP. For purposes of this Agreement, “GAAP” shall mean generally accepted accounting principles used in the United States.
1.2 Defined Terms. All capitalized terms used in this Agreement shall have the meanings ascribed to such terms as set forth throughout this Agreement.
ARTICLE 2
To see the entire agreement, it appears you will have to purchase it.

Chad Youth Enhancement Center

http://nospank.net/chad.htm
Handle With Care: The state continues to license a Midstate youth treatment facility where two have died and many others have been abused
By Elizabeth Ulrich, Nashville Scene, November 8, 2007
The Chad Youth Enhancement Center is a privately owned residential treatment facility nestled in the rolling hills off of a winding, two-lane road just southeast of Clarksville. Barns fashioned out of untreated wood and horses tucked behind white fences dot the pristine grazing land that leads to the facility’s 20 tree-lined acres.
Just a few yards from an empty pasture marked by a few intermittent hay bales, Chad’s gym, school building and three dormitories sit, looking clinical and quite unremarkable. Chad is a place where kids—some criminals or drug addicts, or with serious emotional and behavioral disorders—go to get help. All are between the tender ages of 7 and 17, and most have problems so severe that other facilities will not admit them. It’s what Chad prides itself on: taking the most troubled and disadvantaged children “to overcome those obstacles that may be hindering their healthy emotional growth.”
Chad is also a place where two teens have died in two years. And where allegations of excessive use of force, and verbal and physical abuse at the hands of the facility’s staff have slowly piled up in the offices of Tennessee state regulators for nearly a decade.
In 2005 medics arrived at Chad to find the body of Linda Harris, a 14-year-old resident from Amityville, N.Y., limp on the floor of the hallway outside of her room.
According to a brief police office report, Harris had“become unruly by not staying in bed and was flashing the boys”when Chad staff pulled the girl’s arms behind her back and escorted her to a time-out room. It was at this point that Harris “became limp and fell on the floor”and the Chad staffers sat down next to her and held her arms behind her back as she lay on her stomach.
After approximately 30 seconds, according to the report, staff let her go as Harris remained belly down and appeared to be crying. A few minutes later, the Chad employees noticed that her breathing had slowed, so they rolled her over and called 911. While an ambulance was en route, Harris stopped breathing. She was pronounced dead after arrival at Gateway Medical Center in Clarksville.
But law enforcement told a different story: a local sheriff’s official said their office received a call that night saying that Harris had stopped breathing after being physically restrained by a male Chad staffer who fell to the floor with the girl while redirecting her to the time-out room.
Either way, Harris died only a few days after a New York judge sent her to Chad for emotional problems that had become too much for her father, a single dad, to handle. And either way, Tennessee medical examiner Dr. Bruce Levy ruled Harris’ death “natural.” After all, she was morbidly obese: Harris carried an estimated 400 pounds on her 5-foot-6-inch frame. Plus she was asthmatic.
While the Montgomery County Sheriff’s Office investigated Harris’ death, they didn’t bring any charges against the Chad staffers who restrained her. Levy ruled that her death was a result of cardiac hypertrophy—an enlarged heart because of her chronic bronchial asthma. Harris’ weight was a contributory cause of her death, Levy found.
So life at Chad moved along.
In a November 2005 visit to the center, Department of Children’s Services (DCS) licensing consultant Linda McLeskey noted that more Chad residents felt unsafe at the facility than at other programs DCS had encountered. Less than one month had passed since Harris met her death at the hands of the very people enlisted to help her. And the effect it had on the resident psyche was lasting. “When asked why they felt unsafe, [residents] often reported they were afraid to be restrained because they didn’t want to be hurt,” McLeskey wrote.
Sue Marshall—not her real name—worked as a licensed practical nurse at Chad for roughly one year and recalls the effect that Harris’ death had on residents. “A lot of girls were having nightmares at night after that because probably none of them had seen another person die,” Marshall says. “And you know, of course the first thing they are going to assume is that the staff was at fault.”
According to one expert on restraint asphyxia, those girls may have been right. After reviewing Levy’s autopsy report and police files on Harris’ death, paramedic and author Charly Miller concludes, “It doesn’t fly that her death was natural.”
Though Levy says he stands by his original findings, he tells the Scene that “to some extent that we can’t quantify,” Harris’ death was caused by “the stress of the situation she was in.”
Miller says it’s quite possible that it was the restraint that killed Harris, especially because Chad staff held her on the floor—belly down. Miller says patients with abdominal fat have an increased risk of restraint asphyxia for one simple reason: when an obese person is forced to lay on their belly, the excess stomach fat pushes up into the lungs, making it difficult to breathe until finally, the lungs give.
“But they can keep moving because their extremity muscles are still working after their diaphragm gives out,” Miller says. “And uneducated restrainers think,‘Oh, well, they must be breathing because they’re moving.’ That’s not true.”So Chad staffers might not have realized that Harris had stopped breathing until it was too late, Miller says.
Before Levy even ruled that Harris died of natural causes, DCS—the department that, along with Tennessee’s Department of Mental Health and Developmental Disabilities, was licensing Chad—stopped placing Tennessee children there. New York stopped too. “All we knew was that a child had died under unknown circumstances,” says DCS spokesman Rob Johnson. “The department already had some concerns, so they just elected to go ahead and pull the remaining children out.” Most of those concerns were about Chad’s use of restraint.
But Tennessee regulatory agencies did not revoke Chad’s license, which meant that other states—Kentucky and Pennsylvania, for example—continued sending children there. When asked why Tennessee regulators would keep Chad’s doors open when they wouldn’t even send the state’s own kids there, Johnson says it was simple: Chad met the state’s licensing standards.
“It’s somewhat akin to, does a restaurant pass standards for health inspections when they go in there?” Johnson says. “Yes, they may pass the standards, but it may be that the health inspector may not choose to take his own family there to dine. It’s somewhat analogous. Tennessee has its standards for how it wants its children to be treated when they’re in state custody.”
Chad is where DCS sent Sharon Pruett’s 16-year-old son, John Boy, for rehab in 2004. It’s where Pruett says her son became a broken boy after a counselor pushed him up against a wall, kneed him in the groin and strangled him until three staffers pried the man off of the teenager.
When Pruett moved her family from Chicago to rural Tennessee, she had grand visions of her two kids growing up in a small town in the friendly South, away from the hustle of big-city life. But even in the town of Hurricane Mills—home of Loretta Lynn’s Coal Miner’s Daughter Museum—Boy, a baseball player who did well in school, found trouble.
Before he was 16, Boy was addicted to methamphetamine. Pruett suspected that he was using drugs, and she says state officials told her that she could not get him into a treatment center unless she filed charges against him for being unruly. When she did, a judge ruled that Boy was a danger to his mother and younger sister and, against Pruett’s wishes, placed him in DCS custody. Soon after, Pruett says DCS put her son on house arrest for a 90-day, in-home treatment.
When Boy overdosed in September 2004, Pruett took him to the emergency room. DCS caseworkers soon followed to take a scared, sobbing Boy away to Chad in the wee hours of the morning. It was his first time away from home.
DCS officials told Pruett that her son would stay at Chad only temporarily—until they could place him in another drug treatment program. Pruett couldn’t understand why Boy would be living in a facility—and sharing a bedroom with—children those in the mental health world dub “level three” residents, kids who are a mere step away from being locked down in a detention center or placed in a full-on psychiatric ward. “My son was never arrested,” she says. “My son is not a bad boy. He did not burn houses. He did not hurt anybody. He was hurting himself with a drug problem. I questioned, I begged, I cried, I did everything [to keep him out of Chad].”
Less than three weeks into her son’s stay, Pruett got a call from her son and his therapist. “Mom, I was attacked last night,” Boy said over the therapist’s speakerphone.“You need to get me out of here.This man attacked me, and he broke my glasses.”
Pruett just began to cry. But Boy wouldn’t go into more detail, Pruett says, because he was scared it might happen again. He didn’t tell her that he hadn’t slept much since the attack the night before, which began after Boy called counselor Calvin Nelms a “f**king dick” when the man accused Boy of stealing another resident’s toiletries.
He didn’t say that Nelms had grabbed him by his shirt collar, pressed his hands against Boy’s throat, lifted him up off the floor and slammed him against the wall before throwing Boy down, kneeing him in the groin and strangling him until three employees intervened.
But Boy did tell his mother that his attacker was still working at Chad. Pruett says the facility acknowledged that they couldn’t fire Nelms because they were understaffed. Later, the family found out that Nelms, who admitted that he overreacted, had been placed on probation for his involvement in two or three similar incidents in the year-and-a-half he had worked at Chad, according to DCS files.
When Boy appeared in court a day after the attack, a judge ordered his immediate removal from the facility. Two months later, a Montgomery County court issued a warrant for Nelms’ arrest in the assault. But Pruett never received a subpoena to appear in court on Nelms’charge. His case was dismissed. Photo
Sharon Pruett Photo: ericengland.net
Pruett says Chad was the beginning of the end for her son. Before Chad, Boy was committed to getting better. But when he got home, he just didn’t care anymore. “He was just a different person when he came out of Chad,” she says. “He lost interest. It was like he didn’t trust people. He was just angry.”
She finds it ironic that Chad is dubbed an “enhancement center.”
“This doesn’t improve a child,”she says.“They’re just babies, and they’re going to come out being 10 times worse.”
Things did get worse for Boy. After bouncing among treatment programs for several years, he was shot to death in an unrelated incident in September of last year. But Pruett says she’s still committed to seeing Chad shut down. “How many lives have to be ruined, threatened and how many people have to be killed before they finally shut it down?” she says. “This facility is horrible. And I don’t see that it has changed at all.”
Omega Leach came to Chad from Pennsylvania—one of several states that still sent its most troubled children to Chad after the death of Harris. Leach arrived on May 2, 2007. One month later, he would be dead.
The online message board that accompanied one news story of his death was besmirched with comments keyed in by outsiders—people who dubbed Leach a bad kid who probably would’ve died on the streets anyway. “People out in the general population can refer to a kid who we now know was murdered as being a thug and saying he deserves what he gets,” says Holly Lu Conant Rees, chair of the Disability Coalition on Education of Tennessee. “And what difference does it make whether he dies in a facility or, you know, he gets in a gun battle out on the street? There seems to be a lack of empathy and understanding about the circumstances that led a child to be placed in a facility like Chad.”
To most, he was, quite simply, a delinquent—a boy with a criminal record stretching from his early teens. Leach grew up in Southwest Philadelphia, a rough-and-tumble neighborhood marked by abject poverty and violent crime. In the handful of years before his short stint at Chad, police arrested Leach twice and dubbed him “out of control.” His first offense—threatening students and teachers at his middle school and telling one teacher he would “shoot him full of shells”—landed Leach in a private facility in Virginia before he was even 15.
By 16, he was home again, only to be arrested months later for speeding through Southwest Philly in a stolen Nissan. This time, a Philadelphia judge thought a psychiatric program in the pastoral lands of Middle Tennessee, more than 800 miles from Leach’s home, might do the trick. And Leach wasn’t the first Philly kid to find his way to Chad. The city’s Department of Human Services had been sending children from neglectful or abusive homes there since 2001. And in 2006, the city’s judges began to follow suit, sending a new crop of kids to Chad: those with criminal records.
But Leach grappled with severe emotional issues too. State records show that he had been diagnosed with mood disorder, oppositional defiant behavior and conduct disorder, a condition marked by aggression, the propensity to initiate physical fights and to seriously violate rules and societal norms—such as those you might find in a rigidly structured treatment program.
The American Psychiatric Association would characterize Leach as someone who suffers from a “disruptive behavior disorder.” According to a 2000 report by Wanda and Brian Mohr in the Archives of Psychiatric Nursing, children with conduct disorder share remarkably similar risk factors, such as histories marked by trauma, physical abuse or neglect.
Janice LeBel, director of program management for the Child and Adolescent Division of the Massachusetts Department of Mental Health, has worked 20 years in the oversight of residential programs for children with the most severe mental and behavioral disorders, and she says she’s yet to see a youth with Leach’s diagnosis who doesn’t also have a history of trauma.
And according to the Mohrs’ research, children in treatment facilities who suffer from such disruptive behavior disorders also have another commonality: they’re more likely to be placed in some sort of restraint.
Given Leach’s diagnosis, it’s not a surprise that, when a Chad counselor confronted Leach and told him to leave his dorm room on the afternoon of June 2, Leach reportedly shoved and then tried to choke the counselor.
As the two struggled into the hallway, one of the facility’s surveillance cameras caught what would be one of the last acts of Leach’s young life. Sgt. Brian Prentice with the Montgomery County Sheriff’s Office says the tape shows Leach and the counselor rolling around in the hallway in a “full-on fight.”The pair then spilled back into Leach’s room—away from the camera’s eye.
Another counselor and a nurse then ran into the room as the first counselor walked out, seemingly exhausted. The rest of what happened in that room is speculative. According to statements, it seems that a counselor restrained Leach stomach down on the floor of his dorm room with his arms bowed behind his back.
The surveillance camera didn’t catch anything else—except the staffers later sprinting from the room in a frantic search for a defibrillator. Leach was dead.
But staff accounts of what happened in that room didn’t account for one thing: strangulation. When Levy performed an autopsy, he says Leach “had a series of superficial injuries from the struggle all over his body—kind of what you would expect from that type of a close physical struggle, falling on the ground, rolling around.” That accounts for the fight in the hallway.
But Levy also found “scattered superficial blunt force injuries” and “hemorrhages into soft tissues and muscles of the neck.” They were injuries that Levy says were “certainly consistent with some kind of strangulation.” Because of those findings, Levy ruled the death a homicide.
The two counselors involved in the restraint, Milton Francis and Randall Rae, have been suspended from Chad pending the results of a Montgomery County Sheriff’s Office investigation. Neither has been formally charged in Leach’s death. Photo Omega Leach Photo: Courtesy of the Philadelphia Inquirer/John Sullivan
Incident reports outlining Chad’s physical holds from the last two years alone stack inches tall. Most appear to be hastily handwritten, and many tell chilling, albeit scant, tales of run-ins with residents that resulted in “protective holds.” During a hold, at its least severe, a resident will be held upright with their hands and arms pinned behind their backs. At the worst, a hold can bring a swift and strong “takedown” to the ground, where a resident will be held, face down, arms bowed behind the back.
In May 2006, staff placed a boy in a hold, subsequently breaking the rotator cuff in the boy’s left shoulder—an injury that required a trip to the emergency room, but apparently did not require staff who recorded the incident to go into any great detail as to how the bone was broken when reporting the event to the state. The next month, another boy was “out of control and being aggressive to staff,” according to staff who placed him in a hold. But again, they left out details of how that hold put a gash in the boy’s chin that was severe enough to merit a trip to the ER for four stitches.
It’s not supposed to be this way. Chad adheres to the Handle With Care method of restraint. And according to its brochure, the program’s primary restraint technique—the method that Chad uses with residents in a standing position—gives staff an “unprecedented mechanical advantage without pain or injury.” In the event that staff find an upright hold insufficient and initiates a takedown, the brochure boasts, “there is no impact.”
Still, by many accounts, Handle With Care—at least as it’s used at Chad—is infused with anything but gentle care. When she worked at Chad, Marshall says she would see staff restrain residents “too hard and with anger vs. discipline.” In fact, the first time she saw one of the physical holds in action, it was more than she—a nurse of almost 20 years—could bear. “I ran out of the building crying because I didn’t know that kids—human beings—could be treated so forcefully,”she says.
The facility’s Behavioral Health Incident Report logs for 2006 show that staff physically restrained as many as 10 residents in a single day. In his investigation of Chad, Terry McMoore, director of Clarksville’s Urban Resource Center, found that Chad made 216 911 calls since October 2001, 33 of them for ambulances.
While experts warn that death can occur within six minutes of a hold, many Chad residents endured restraints—for three minutes, 15 minutes, 20 minutes or more—and escaped physically unscathed. While Chad’s own policy dictates that such holds can be used only if a resident’s behavior is violent enough to destroy property or harm the resident or others—never as punishment or retaliation—the facility’s own records tell a different story.
When a resident identified as a “little boy” left his bed in a wing of the facility that staff called the “Little House” one night in April, it wasn’t long before he found himself in a hold. One Chad staffer described it this way: “Little Boys [sic] not wanting to go to quiet time or bedtime. He came out of room again and was escorted by Ms. Jennifer but struggled with her.” Staff then placed the boy in a standing hold for three minutes.
Less than a month later, staff placed another resident, whose gender was not specified, in a hold for 15 minutes after the resident “began to escalate” when he or she wanted to retrieve a tennis ball in one of the facility’s classrooms. Marshall says such school-day restraints were common. “If [a resident] would continue to act up through the class period and so forth, it would end up a restraint,” she says.
According to Chad documents, residents were restrained for the simplest of childhood acts or missteps—even the proverbial glass of spilled milk. When one girl began crying alone in a corner of the facility in May, she refused to tell Chad staff what was wrong. Instead, she asked to speak to a supervisor. But when she grew weary of waiting, she walked out of the room and headed out of the building. Staffers put her in a standing hold for three minutes. When recording the reason for the restraint, a Chad employee checked the box next to “in danger or has harmed self, as evidenced by behavior or ideation.” The report failed to mention how the girl acted dangerously.
Three days later, staff restrained a boy when he walked up to a Chad employee, who already had another resident in a hold, and simply implored the staffer to “let him go.”
Other incident reports describe the facility as a chaotic place. In July, staff member Jermaine Clemmons was walking through the facility’s cafeteria where he found residents loud and out of their seats. He asked a female resident what was happening. The girl then threw milk at another Chad employee because, according to a report, the staff member was “saying things about her.” After one staffer unsuccessfully tried to escort the girl from the cafeteria, Clemmons placed her in escort and transported her to the education building, where she “was non compliant [sic] and was simply placed in a standing hold.”
That simple placement lasted 20 minutes. Clemmons didn’t provide any other details about the hold or any explanation as to exactly how the girl was noncompliant, or how she had become a danger to herself or others.
When the Scene asked if such force—and if as many as 10 restraints a day—in a therapeutic environment seems excessive, one industry expert offers an audible sigh. “That’s real violence going on,” Janice LeBel says. “That’s horrific risk for the youth and for the staff. And I think, over time, when staff aren’t given other tools, [restraint] becomes confused with a treatment intervention. But there is nothing therapeutic about it at all.”
But Tennessee’s Department of Mental Health and Developmental Disabilities has a different answer. Tracey Robinson-Coffee, director of licensure there, says she can’t answer questions about whether Chad’s restraint count is excessive because “to be fair, you know, you’re not dealing with the average population of youth out there....It’s not like everybody is doing as they’re being told: Get up, go to school, go to lunch, whatever. There’s things that happen in the facility, and I can’t say that one [restraint] a day is not excessive or it is excessive.”
There are many experts in the mental health field who believe that, for children who have been abused or have experienced some sort of trauma, physical restraint can be all the more agonizing. In testimony before the National Council on Disability, an independent federal agency, mental health service provider Marcie Kelley characterized her experience being restrained: “As a survivor of sexual abuse, I personally have found the use of restraints on me more traumatizing than being sexually abused. Being put in restraints is a much longer, traumatic ordeal than being raped.”
But Bruce Chapman, creator of the Handle With Care method, sees it quite differently. On his website,The Compassionate Neanderthal, and in a collection of his “unsolicited commentary,” Chapman writes that children in crisis “‘get the difference between doing something for a child and doing something to a child.” And where many advocates and abuse sufferers see restraint as traumatizing, Chapman writes, “On the contrary, it can be a moment of healing when the physical contact is initiated out of genuine concern and duty to the child.”
Even so, Chapman advises: “No person in his right mind wants to wrestle with a kid if he or she doesn’t have to....If you know childcare workers within your agency who routinely place themselves and children at risk, you have a bigger problem than Handle With Care training can fix.”
By DCS’s own account, Chad has had a constant turnover of employees, many of whom are college students and military personnel from the Clarksville area. And according to former Chad employees, it was these untrained applicants—those without any experience working in the mental health field or with kids with such extreme mental and behavioral issues—who would become the resident counselors who worked the most closely with Chad residents.
“They could have been someone who worked at Burger King and came out and put in an application to be a [resident counselor],” Marshall says.“These are the hands-on people who are with the kids 24-7.They’re people just right off the street that go through a week orientation program, and there were times when there were people there who weren’t over 20 or 21 themselves.”
There is little indication that Chad has been exceedingly selective in its hiring process. During its 2005 annual inspection of the facility, DCS reviewed nearly 20 staff files and found that only five contained documentation of references, but none had the required three references.
But all Chad employees are trained in Handle With Care—everyone from the nurses and teachers to the cafeteria workers, Marshall says. In fact, many are trained more than once, some on an annual refresher basis and others after particularly violent incidents of restraint. According to Chad’s policy, all employees undergo eight hours of training in Handle With Care upon hire.
In documents obtained by the Scene, nurse and former Chad employee Charles Wood wrote that most training in-services were “a joke” where “all answers were given at each booth,” so staffers had “no reason to learn them.” Wood reported that he attended all of the in-services, from Handle With Care recertification to suicide prevention, in approximately one hour. And Marshall says the initial week of orientation was the most—and often the only—training counselors had before working with residents.
LeBel says the behavior children can display in facilities such as Chad is absolutely frightening for staff who don’t have adequate training.“You can’t effectively ask people to step into a setting with children with mental health needs if they haven’t been educated,” she says. “Some providers require two weeks, one week [of training] and it varies...but until staff have been educated to understand what they’re looking at, particularly trauma and the impact of trauma, they can’t possibly know the needs of the youth that they’re serving.”
DCS had concerns about Chad’s staff too. In November 2005, McLeskey visited Chad on behalf of DCS and interviewed 55 residents. According to her report, residents said they heard staff call children “stupid” and “retarded.” Two staff members also reported hearing staff use derogatory names with residents. But it hasn’t been enough to stop licensing the facility.
McLeskey thought it necessary to remind Chad that “verbal abuse, ridicule and humiliation” are not acceptable forms of punishment, and she asked administrators to train employees to deal with resident behavior without resorting to abusive language. “Our impression is that there are a large number of immature employees who may not have the skills or the training necessary to deal with the issues and behaviors of the residents at Chad,” McLeskey wrote.
Denna Smith was 44 years old when she started working as a counselor at Chad in December 2005. Smith had been working 40-hour weeks at the center for less than two months, making $8.50 an hour, when she received a “corrective action notice.” Though the notice doesn’t detail Smith’s behavior, the supervisor outlines that she would be placed on “coaching status” so that she could learn to “remain calm and in control” when dealing with residents.
The supervisor writes that the “situation you’re being counseled on was handle [sic] the wrong way, especially when you know what kind of resident your [sic] working with.” Though the resident’s name is redacted, the supervisor identifies the child as “one of the most confrontational, defiant residents” at Chad.
The supervisor created an “action plan to achieve required performance” for Smith to follow: She would take a Handle With Care refresher course. About four months later, two Chad employees filed handwritten complaints about Smith, who, despite that refresher, didn’t seem to have calmed much.
According to one staff report, two girls began horseplaying in the cafeteria line when one employee reprimanded them. But Smith stepped in and yanked one of the girls out of the line and into an adjacent room, where another employee saw that Smith “threw her stuff out and was getting ready to fight.” Others reported seeing Smith moving toward the girl and saying, “You want to fight me? If you want to fight, let’s go.” In a report to Tennessee regulators, Chad’s risk manager wrote that Smith then shoved the girl.
When confronted about the incident, Smith denied it, became defensive and said, “I don’t have to take this shit” and quit. But it seems Smith had been verbally abusive long before she stormed out of Chad—the shoving incident was merely the catalyst for employee disclosure.
One staffer recalled a fight between Smith and another employee where the women exchanged insults, calling each other a “bitch” and “fat hog” in front of residents. Another counselor writes of an evening when a girl waiting in line for dinner asked what time it was, and Smith told her “that she was fat enough and that she was going to eat eventually.” The counselor said the girl went into the lobby for a timeout and returned crying.
Buddy Turner, divisional vice president at Universal Health Services (UHS), a King of Prussia, Pa., for-profit corporation that owns Chad and more than 100 other behavioral health facilities across the country, says UHS bought Chad in the fall of 2005 along with a handful of other facilities. When asked if it is indeed typical for Chad to hire counselors with little to no experience in the mental health field, Turner says they try to give priority to applicants with degrees and any human services experience. “There are employees that come to us that have not had experience working with kids, but again, those individuals, if they’re hired, go through an extensive state-approved training plan before they ever work with kids.”
But once they complete that training, virtually anyone at Chad can place a child in a physical hold. While Chad’s protective hold procedures outline that licensed practitioners (LIP)—doctors, nurses and licensed clinical social workers—must approve the use of a hold on a resident, any employee with a bachelor’s degree or two years experience working at a mental health inpatient facility will do the trick in the absence of an LIP.
Disability Coalition on Education in Tennessee’s Conant Rees bristles at the policy. “Good mercy,” she says. “I don’t see where there would be any preparation in completing...your bachelor’s degree in how to safely engage in a pretty intense, high-level behavioral intervention—one that has life-threatening implications.”
In 2005, the Montgomery County Sheriff’s Office called DCS to report that three of Chad’s male residents had beaten and attempted to strangle another male resident at the facility. Even though the state requires Chad to report incidents of harm immediately, this was the first DCS had heard of it.
Chad didn’t report the incident to law enforcement either. Sheriff’s officers got the news from the resident’s sister.
So DCS gave Chad 30 days to retrain its staff on the state’s reporting requirements for suspected abuse and neglect. Two days after the sheriff’s office made that call to DCS, Chad had a staff meeting to hand out a new reporting policy to its staff “to read and ask questions,” the center’s director of human resources reported. And Chad promised to teach new hires about the revamped policy.
The new policy outlined a clear chain of command for reporting harm or suspected abuse and neglect: notify the nurse on duty, who will then contact the Chad administrators, who should report the incident to DCS. At this point, staff are required to make documented attempts to reach the resident’s family. And the supervisor of nursing determines whether the resident should be transported to the emergency room.
It’s a familiar cycle that Tennessee regulatory bodies have developed with the facility: They identify the facility’s shortfalls, Chad responds—action plan in hand—and promises to fix said shortfalls. Inevitably, Chad continues to err.
State official Robinson-Coffee doesn’t see it that way. “It’s not like they were a red flag in our office,” she says. “We just go out and do our surveys and investigations when we got complaints, and they rectified whatever the situation was at that time. I mean, I wouldn’t put them in the category of a problem facility.”
She might not, but one Kentucky family would.
When the family of a 13-year-old boy placed their son in Chad on June 1, they were hopeful. Their son had never committed any sort of crime and, unlike many Chad youths, had not been ordered to attend treatment by a judge. His family enrolled him voluntarily for medical care.
On Aug. 26 of this year—less than three months after he began treatment—another 13-year-old male resident raped him.
According to a Chad incident report, the Kentucky boy was in a bathroom stall at the facility when he was approached by another resident who began banging on the door and threatening him. When the boy opened the door, the resident pushed his way into the stall and told the boy that if he didn’t pull his pants down, he would hit him.
When the boy refused, the resident hit him in the back and forced penetration on him while holding the boy’s mouth shut. Before leaving the stall, the resident threatened the boy and told him to stay quiet. And the boy did, for five minutes as he sat alone in the stall, before he cleaned himself off and told a friend what had happened. That resident notified Chad staff.
The victim’s mother was at the family’s Kentucky home on Sunday evening when she got a call from Chad: Her son had been raped. Rebecca Blair, a Brentwood attorney hired by the family, says her best estimate is that it took anywhere from one to three hours for the family to find out about the assault. Chad records show that it took nearly two hours.
When the boy’s mother asked if anyone had called police, Blair says the Chad supervisor told her it was not protocol. They called DCS— not the police. Then she asked if her son had been taken to the hospital for medical treatment, but she received the same answer: It was not Chad protocol.
The woman insisted that her son be transported to a hospital, and eventually, her pleas wore Chad staff down. Still, it took her nearly an hour to convince them. And by the time the boy arrived at Gateway Medical Center in Clarksville for examination, several hours had lapsed since the attack. And it wasn’t until after midnight that someone at the hospital called police to report the incident.
According to a Chad incident report, the boy returned to the facility a little after 3 a.m., and was transported to Nashville General Hospital and then to Our Kids, a Nashville treatment center for children who’ve been abused. It wasn’t until 9:45 the next morning that the boy made his way back to Chad.
The boy’s family removed him from the facility immediately and placed him at another treatment center closer to home. The suspect, who had come to Chad from Pennsylvania, has since been charged in the rape, taken into custody by Tennessee authorities and transferred back home, Blair says.
The family can hardly understand how such a thing could happen to their son in the first place. “They’re devastated,” Blair says. “And they’re just struggling to cope with this on a day-by-day basis.”
But according to one former Chad staffer, the fear of rape is common among residents. “They were afraid they were going to get hurt sexually by other residents...because they weren’t monitored closely enough, and it only takes a second for a young kid to get raped or for several to gang up on another kid,” Marshall says.
Chad is often understaffed on nights and weekends, Marshall says. Even during the daytime hours, she says Chad operated just at the minimum required staffing levels for the 85 or so residents who lived at Chad during the time she worked there. “You know, you’d call and beg and plead for people to come in and help, and nobody would,”she says.
Residents often told Marshall that they would find counselors sleeping on the job during the night shift. Some residents would use that as leverage. “The older boys would have cigarettes because the counselors at night would give them to them because they would fall asleep and the kids would catch them and they were going to tell on them if they didn’t give them some type of favors,” Marshall says.
Before any Google search of the Chad Youth Enhancement Center returned a multitude of reports on the death of Omega Leach, it wasn’t uncommon for families to research the facility and not find any red flags. “Even kind of knowing the key words to look for, I could find very little information about how this program functioned,” Conant Rees says.
The stress involved in making such a choice only complicates the process. Usually a child is either ordered to treatment by a judge or placed there by his family. And when parents decide to send their kid away from home and into facilities like Chad—centers that are, essentially, the last step before a psychiatric ward or jail—it’s a desperate measure. “Families are often exhausted and have used up their resources and don’t see any other options,” Conant Rees says.
She advises families to visit a facility’s campus before enrolling their child, to get that kind of gut reaction about what really happens behind closed doors. But when the family of the Kentucky boy visited the facility before admitting their son, no one told them that one resident had already died there. “They were shocked and very upset and alarmed that none of that had been brought to their attention when they were selecting this place as a treatment facility for their son,” Blair says.The family had even toured the facility and talked to Chad personnel “extensively before he was admitted.”
Of course, if the Kentucky family were to download Chad’s brochure from the KidLink Network website, a self-proclaimed leading referral source, they probably would’ve been all the more assured. KidLink is owned and operated by a subsidiary of UHS. And just like its UHS parent site, KidLink proudly states its mission: “Finding hope for youth and adolescents who are considered hopeless by others is something we do every day, because for us, giving up on a troubled child is simply not an option.”
Even if families take a closer look at Chad’s accreditation, they’ll find gold seals of approval and stellar marks.
The Joint Commission, a nonprofit group that regulates and certifies more than 15,000 U.S. health care programs, has awarded Chad its highest level of accreditation. And even after the two deaths at Chad, Tennessee’s Department of Mental Health and Developmental Disabilities (DMHDD), which is now the only state agency responsible for licensing Chad, still has not yanked the center’s license.
Mouthpieces for both the Joint Commission and DMHDD give the Scene similar explanations for why a handful of kids are still being treated at the facility today: Chad is trying to make things better.
Joint Commission spokeswoman Elizabeth Zhani says that after the death of Leach, Chad has worked within the commission’s requirements to develop an action plan for improvement. As long as Chad follows those requirements, its gold seal of approval won’t be stripped. “Organizations, when they take these steps, they learn from this,” Zhani says. “We don’t want to create a culture of fear where people are hiding things. We want to create a culture where people are learning from these incidents.”
Robinson-Coffee also seems to think that Chad is learning from its mistakes. She says it’s not the intent of DMHDD to shut it down. She’d much rather see the facility come back into compliance.“I think because Chad has kind of been in the media for so long, there just kind of seems to be a consensus that...there have been a number of incidents, but really in fact, they’ve been in compliance,” she says. “This has been a tragic incident, and they’ve been in the spotlight because of this incident. There are other minor incidents, but again, you have to put it in context of the type of facility they’re running and the population they’re dealing with.”
UHS feels that Chad might be getting an unfair shake in the media as well. In the first interview that the company’s Nashville office has grantedsince Leach’s death,Turner says,“We feel real strongly that thefacility and the company is committed to do the right things with kids.” He says UHS is interested in getting the story told about Chad, at least “the part about our facility treating really the most severely at-risk kids is a real statement about that facility…. We’ve got a successful history doing that, both at Chad and other places too.”
By those “other places,” Turner may be referring to the Compass Intervention Center in Memphis, another UHS-owned residential facility that is now treating an estimated 80 kids who are about the same age as Chad residents and who are generally treated for many of the same problems.
State files on Compass are disturbing. A 2006 report made by a DCS licensing consultant has one resident describing Chad as “better than Compass in Memphis” because “lots of kids get slammed down there.” Much like with Chad, stacks of reports detail resident complaints ranging from injuries sustained in restraint holds—Compass also uses the Handle With Care method—to allegations of staffers making sexual comments to residents. One girl reports that a male employee has asked her “to open her legs.” Other residents report being denied water or being threatened by a staffer who said she would “box [residents] like a grown woman.” One mother alleges that Compass staff laughed at her son and encouraged other residents to make fun of him because the boy had been placed in a private room because of excessive masturbation.
Robinson-Coffee says just as many issues from other facilities come across her desk. “I guess you can probably say it has to do with staffing and the proper training, and that’s something that we need to basically make sure that they’re doing properly,” she says. “But it’s kind of a tough situation all around. It really is.”
It’s an especially tough situation for parents such as Pruett, who don’t know if they will ever be able to move on from what happened to their children at Chad. And explanations from Tennessee’s regulatory bodies haven’t soothed uneasy minds. “Why can’t they just go and have these doors shut and locked up?” Pruett says. “If I were to commit that in my home, where do you think I would be? DCS would take that child out of my home...but [Chad] can do it and get a slap on the hand? I don’t understand why the doors are still open.”
SOURCE: http://www.nashvillescene.com/Stories/Cover_Story/2007/11/08/Handle_With_Care/#authors
Linda Harris Death
Harris was a 14-year-old from Amityville, N.Y., whose developmental age was close to that of a 6-year-old. She lived with her father, a single dad—her mother, a reported drug addict and alcoholic, died when Harris was a girl. According to reports compiled by several New York state psychiatrists, in 2004 Harris struck up an Internet relationship with a 20-something man who later came to her home and raped her. While Child Protective Services and police became involved in the case after a doctor found evidence of the assault, one psychiatrist wrote that "there was no follow-up and the perpetrator was not caught."
Harris began to act out and "gained weight significantly" because of several medications prescribed to treat depression. Later that year, her disruptive behavior landed her in a New York treatment center. But in 2005, she ran away and was placed back at home with her father. At this point, psychiatric assessments describe Harris as a hopeless girl who felt that "no one would miss her if she was gone." When asked what she wished for most, Harris told one therapist that she just wanted a mother.
But Harris' father said he couldn't control her. A psychiatrist recommended that Harris be sent to a "highly structured residential treatment center," and a New York judge thought Chad was the answer.
A mere four days after arriving at Chad, Harris died. According to a brief police offense report—all that the sheriff's office had made public until now—Harris had been "flashing boys" from her bedroom when staff pulled her arms behind her back and escorted her to a time-out room, where she "became limp and fell on the floor." Chad staffers then sat down next to her and held her arms behind her back as she lay on her stomach, according to the report. Once they let her go, it took a few minutes for staffers to notice that her breathing had slowed. They called 911 and started CPR.
But the investigator's files, complete with statements from numerous staffers and children who witnessed the restraint, are much more grim. To punish Harris for acting out that night, staff said that Charles Garner, the counselor who restrained her, moved the girl's mattress into a time-out room, where she was going to be forced to spend the night alone, sleeping on the floor.
When Harris refused, Garner grabbed her and moved her toward the time-out room, where he said she "dropped her body weight," causing the two to fall onto the mattress on the floor—with Garner's 260-pound body pressing down on Harris. But residents who saw the incident didn't call it a fall. One girl told police that she saw Garner "body slaming [sic] her on the mattress."
After hitting the mattress, Garner said he turned Harris' head to the side to help her breathe and continued to restrain the girl belly down on the mattress for a minute. Other staffers can't confirm what happened during the restraint, though—Garner was the only one in the room. By the time several nurses and another Chad counselor did arrive, they found Harris still on her belly. Her face was bloody and she had soiled herself—details that weren't mentioned in the initial police report or even in some staff accounts of the incident.
But many of Harris' peers reported this to police. One resident said: "Someone came in [to my room] and said that the 'fat girl had crapped herself' and when I looked, I saw her feet sticking out of the time-out room. A couple of staff were laughing because she had [soiled herself]." Another girl said that "after a while we started seeing blood [on the floor] and the staff put paper over our window so we couldn't see what was going on."
Staff reports piece together the last few moments of Harris' life. When one nurse arrived in the time-out room and asked Harris if she "was hurting," Harris didn't answer. So the nurse walked out of the room. She told investigators that it was common for residents not to answer questions right after being restrained. One resident reported hearing a nurse tell Harris that if she didn't get up, "we are going to have Mr. Garner get back on you."
Staff reports conflict at this point. One nurse said that when she and other nurses checked on Harris a second time and found her unresponsive, a nurse brought in an ammonia stick to put under Harris' nose. The girl still didn't respond, so the nurse said they started CPR. Another Chad counselor made no mention of the ammonia, but said staffers couldn't find Harris' pulse and then rolled her over and began compressions.
Either way, when paramedics arrived on the scene, they discovered the girl's lifeless body on the floor outside of her room. Residents in the girls' wing of the facility were understandably rattled. Some reported feeling "really scared." One girl said her roommates started "singing soft songs to calm us down."
Still, as violent and traumatic as residents reported the event to be, state medical examiner Dr. Bruce Levy ruled the death "natural." In an autopsy, Levy found that a morbidly obese and asthmatic Harris had an enlarged heart that he says is to blame for her death. Once Levy released that report, investigator Larry Hodge met with Montgomery County assistant district attorney Dan Brollier, and shortly after, the case was closed. In a sheriff's office memo, Hodge wrote that Brollier told him it wasn't necessary to present the circumstances of Harris' death to a grand jury.
Limited Public Report on Investigation of Chad Youth Enhancement Center, now known as Oak Plains Academy.
Chad Youth Enhancement Center
1751 Oak Plains Road
Ashland City, TN 37015
Phone: (931) 362-4723/fax (931) 362-2816
Family Of Teenage Restraint Victim Settle With Facility
PHILADELPHIA, PENNSYLVANIA--The family of Omega "Manny" Leach, 17, a who was strangled after being placed in a restraint hold at a Tennessee treatment center, has settled a federal lawsuit against the facility for $10.5 million. The Philadelphia teenager's family agreed to drop claims against the city and its Department of Human Services, which sent the troubled teen to the Chad Youth Enhancement Center despite warnings that it was dangerous for him. A key piece of evidence was a photograph from a surveillance camera showing a Chad mental-health technician with both hands around Leach's neck as he pinned him to the floor.
Even though Mr. Leach's death was ruled as a homicide, no criminal charges were ever brought against the Chad Youth Enhancement Services employee.

Sealant Recommended By DentaQuest, formerly Doral

Many know, but some do not, that states usually contract with a company who then subcontract with dental providers to get the care to the medicaid patients.  Doral is described as a dental benefit administrator. 

At its LinkedIn webpage it is said: "Doral, is a subsidiary of DSM and DentaQuest, a dental benefit administrator operating in the government sector serving nearly 50 clients, 12 million members in 24 states and the District of Columbia, and approximately 17,000 participating dentists. The mission of DSM is to improve oral health."  (put another way, Doral or DentaQuest is a government contractor)




However in searching Doral, you are directed to dentaquestgov.com,  (the gov part a bit misleading) where it says Doral and ADI have merged to become DentaQuest.

Here, guys, check it out:  DentaQuest recommends sealants.  


Hey FORBA/Small Smiles, Kool Smiles, Ocean, Smile Starters, Adventure....  think you might need to check this out!!!!!!   Root canals are NOT the first choice in treatment for God's sake!!  But it is the one that pays you the most!

Free CE for Small Smiles, Kool Smiles, Adventure Dental and Ocean Dental Dentists

After spending some time today pursuing FORBA's website, set up for their Small Smiles clinics I found a link to the American Academy of Pediatric Dentistry's Behavioral Control Guide for dentist,  and support staff.  Low and behold, FORBA is clear on these techniques!  They know what to do and when to do it!  OMG!  I need to check Kool Smiles to see if they have a link as well so that I'm sure they know too.

I knelt and thanked the Lord.

What I began to wonder though was, "Does or has anyone at FORBA read it"??  Just asking...

My guess is by adding a link on their website to the guide along with the statement above the links, they are trying to send a subtle message that your child is safe and they know what they are doing.  


These Guideline were adopted in 1990 and have been revised 6 times with the last being 2008.  Soooooo.... these were the guidelines in place when good ole Dr. Spaghetti Eddie and Dr. Meatball Mike DeRose laid out their sinister plan to be the Kings of the dental kingdom.

Anyway, back to the Guidelines, let me give you a few snippets:....

Kool Smiles Ad For Employment Reveals Disregard For Quality Care

Dentist, Kool Smiles - El Paso, TX

Dentist, Kool Smiles - El Paso, TX

Kool Smiles is a general dentistry group that is providing kids and their parents in underserved communities with the dental care they desperately need.  As a dentist, you get to focus on taking care of your patients, while we take care of the business itself! [which means they tell the dentists what to do and when to do it, via the 'lead dentist and office managers] Our offices are brand new and equipped with ...

FORBA Small Smiles Employees CIA Compliance Is Up To You; Includes Warning To Future Employees

ATTN:  All FORBA Small Smiles Employees

ATTN: Potential Employees: This is a must read before you agree to be employed by FORBA or any of its Small Smile clinics.  Full disclosure is a must!

FORBA has entered into a Corporate Integrity Agreement (CIA) with the Office Of Inspector General (OIG) after being caught red handed committing fraud and mistreating children.  (not only red handed but on video!)

Of course FORBA admitted no wrong doing as they will be quick to tell you.  However, anyone who would rather pay $24 million dollars plus interest and sign a 67 page set of rules to follow for the next 5 years, is probably guilty in my opinion.

[I would say FORBA was probably thinking this was a deal compared to what might happen if they didn’t agree and further delving into FORBA’s setup would likely reveal much worse things happening, that’s a scary thought isn’t it?]

When push comes to shove, it’s you, the employee on the front lines to see that the provisions in the CIA are followed.  I would highly recommend you download and take time to read the rules since you are the main one playing the game.  It’s your butt out there.  You may not have signed it, but you are as legally bound by this agreement as if...

Kool Smiles Offers To Sponsor Forgein Nationals To Come To US And Fill Their Clinics

I knew this was happening, but hadn't heard anyone of these dental mills putting it out there.

If you're a dentist who would like to continue your dental career in the U.S., Kool Smiles can help you obtain a work visa and a full-time position. Sponsorship will be considered on a case-by-case basis.

See Here

Not that this is a problem, but it kinda is a problem.

They also say they have a "Unique" Wealth Management Plan for dentists.  God only knows what that really is!  Maybe someone could tell us.

Has anyone ever wondered exactly what NCDR of Kool Smiles stands for:  National Children's Dental Research.

DPMS stands for Dental Practice Management Services. 

Appears Kool Smiles has the bonus program just like Small Smiles.  Here is an ad:

Opportunities Available in South Texas and Arkansas. Earning Potential Up To $250K (Salary + Bonus)! Change the World, One Smile at a time!
$10K Sign On Bonus! It’s a Kool Concept!
Full-time dentists earn a guaranteed base salary plus a monthly bonus based on individual production. In addition, company paid benefits include malpractice insurance, life insurance, and short and long term disability. Medical, dental and vision are also available for all employees and their families. We offer the innovative Kool Smiles Wealth Management plan - a company matched saving plan that allows you to set aside more savings every year than a traditional retirement plan. Other benefits include paid time off, company holidays, reimbursement for continuing education, licensure fees and profession dues - and much more!
Please call or email to learn more about other full-time and part-time opportunities in AZ, AR, GA, IN, MA, MS, SC, TX and VA. Relocation package available.
Ryan Murdock p/ 770-916-7044 rmurdock@ncdrllc.com