Showing posts with label ReachOut Healthcare America. Show all posts
Showing posts with label ReachOut Healthcare America. Show all posts

Tuesday, January 24, 2017

3rd Grader’s Teeth Removed at School by Mobile Dental Clinic; Then Had to Walk Home!

Outrageous? Indeed it is! Sadly I still hear these stories about children, in essence, tortured by unexpectedly having teeth removed by these school dental programs.  This time it’s in Baltimore. Although it’s unclear, in my opinion it’s very likely Reachout Healthcare’s Smile America Partners that is owned by Morgan Stanley investments.  I would love to see the permission slips sent home to parents. If anyone has one, please email to

Other websites include:

From Smiles Programs website:

imageSmile Programs is currently active in 24 states and has ongoing strategic partnerships with Detroit Public Schools, Chicago Public Schools, the School District of Philadelphia, Boston Public Schools, Baltimore City Public Schoolsimage, Indianapolis Public Schools, Cleveland Public Schools, LA Unified Schools, Prince George's County Public Schools, Washington DC Public Charter Schools, Phoenix Area Public Schools, and St. Louis Pubic Schools as well as many others.



Mom Outraged, School Dental Program Removes Child’s Teeth Without Her Knowing

BALTIMORE (WJZ) — A mother is outraged after her third grader came home from school with three of his teeth missing. She says his elementary school performed a dental procedure she never knew about.

A Baltimore City mom is looking for answers: Why did the school allow serious dental work — without making a single phone call to parents.

9-year-old Michael is still brought to tears by the pain. He’s now missing three teeth — pulled out by a dental program visiting his school. His mother, Shanda Flemming, tells WJZ she never was notified that the procedure was happening.

“And then two on this side. One top and one bottom,” says Flemming.

Baltimore City Schools says Flemming signed a permission slip, but Flemming thought it was for routine cleanings.

“I’m angry about this. I don’t think that it should have happened like that,” says Flemming.

She says she was blindsided when Michael came home with a swollen mouth.

“They just said they was gonna clean my teeth,” says Michael.

Read Entire Story Here

Thursday, May 14, 2015

Report on Indiana dentist Shadrach Gonqueh may have missed the real story

Below is a story from about yet another overtreating, Medicaid defrauding crooked dentist published May 12, 2015. In the story they mention the 2014 OIG Report about 95 dentists with “Questionable” billing. That’s where the real story lies.  Why do I say that, you ask? Well, out of those 95 dentists 28 work for Kool Smiles clinics, owned by FFL Partners, 13 work at clinics that were formerly named Small Smiles, also owned by private equity investors, and 10 work for Reachout Healthcare America’s “Smile Care” mobile clinics that tend to visit schools. The list of dentists is at the end of this post.

Indiana dentists accused of overtreating patients, overbilling Medicaid

May 12, 2015

INDIANAPOLIS (WISH) – Kyong Farnsley feared she had cavities in her teeth.

She hadn’t been to the dentist in a while.

So in August 2012 when she walked into Amazing Family Dental in Indianapolis, she says she expected to have an initial exam and a treatment plan set up.

Farnsley says she walked out with half her teeth.

“(The dentist) proceeded to do the exam and told me I had an infection in my mouth and that some of my teeth were infected. He would need to pull them,” Farnsley told I-Team 8. “He said the infection was so bad that if I didn’t have (my teeth) pulled out, I could walk out and have a heart attack and die. I had never heard that before.”

Fearing for her health, Farnsley said she gave consent for Dr. Shadrach Gonqueh to perform the procedure. A copy of her dental records, obtained by I-Team 8, show 15 of her teeth were extracted.

“If he says it’s that severe and I’m going to die, I am going to trust him. I have two small boys at home. I can’t leave them. I am a single mom at that time; I can’t leave them,” she said.

Afterward, Farnlsey said she was given pain medication but no antibiotics. She left, she says, thinking she would eventually receive dentures. As weeks went by, she sought a second opinion from a new dentist who she says told her the procedure she endured was unnecessary.

Farnsley’s story is not unique. She is currently one of five former patients suing Dr. Gonqueh. Another lawsuit representing three former patients claims Dr. Gonqueh made them “believe that they were in imminent danger and needed to immediately have all their teeth pulled … or risk death by suffering a heart attack,” according to the lawsuit.

An I-Team 8 investigation found allegations of “dental overtreatment” or unnecessary work is not uncommon. In fact, it makes up nearly a third of the 44 active licensing complaints against Indiana dentists, according to Indiana Attorney General Greg Zoeller’s office.

In March, Zoeller’s office filed a licensing complaint against Dr. Gonqueh, accusing him of engaging in fraud by overbilling and receiving more than $27,000 in reimbursements for procedures performed on 158 patients.

“The Board of Dentistry is expected to consider this complaint at its hearing on June 5. At that time, the board will act as jury and judge to determine what, if any, disciplinary action will be taken against the license holder,” Molly Johnson, a spokeswoman for Zoeller’s office, wrote in an email to I-Team 8.


I-Team 8 spoke to Dr. Gonqueh by phone at his Raymond Street office, where he is still practicing. After a reporter identified himself and informed Gonqueh that he was recording the conversation for his news report, Gonqueh declined to answer questions, but did say:

“This story is nothing new,” Gonqueh said. “And I will refer you to my attorney for any further comments. I think you are looking for something where there is nothing.”

Gonqueh’s attorney, Peter Pogue, provided a statement that read:

“Amazing Family Dental, and its dentist, is aware of the recent filings by a few patients and the Attorney General’s Office.  These claims arise out of treatment from several years ago. Amazing Family Dental and its dentist is vigorously defending each of these claims as they proceed through the appropriate legal venue, and Amazing Family Dental and its dentist intend to avail itself of all appropriate legal defenses.  Amazing Family Dental and its dentist maintain that the treatment of each patient is medically appropriate and within the appropriate standard of care, and Amazing Family Dental and its dentist look forward to the opportunity to present the defense to these claims at the appropriate time and in the appropriate forum.  Beyond that, Amazing Family Dental and its dentist do not feel that it is appropriate to comment on pending legal matters.”

(Editor’s note: In the days leading up to this story, I-Team 8 received repeated phone calls from another lawyer, Steve Eslinger of South Bend, who claims to also represent Gonqueh.)

Eslinger’s statement said in part that “expert witnesses” contend that Dr. Gonqueh did nothing wrong.


Last November, the Office of Inspector General from the U.S. Department of Health and Human Services issued a report on pediatric dentistry in Indiana that found “questionable billing practices” among 95 dentists in the state.

Tuesday, August 20, 2013

Ever wonder just what caliber of dentists the ADA considers distinguish enough to be a District Trustee?

Thomas FloydHere is why their judgment should not be trusted.  

Maybe you remember Dr. Thomas Floyd from his mug shot? No? 

Well, maybe the news reports below about the distinguished gentleman (sarcasm) will jog your memory. Or educate those who are familiar with Dr. Thomas Floyd.

Below is an announcement by the ADA stating what a glorious event the “Medicaid Challenges and Strategies Symposium” of 2008 turned out to be, which included the leaders of each of the ADA’s 17 "trustee districts” 


August 04, 2008

Medicaid challenges, strategies examined

By Stacie Crozier

Seventeen private practice dentists—one from each ADA district—who logged at least 1,000 Medicaid and State Children's Health Insurance Program patient visits in the last year gathered at the ADA June 23 to identify challenges and successful strategies for improving access for this population group.

[We all know Dr. Thomas Floyd probably logged that many a week! Wonder what the other 16 dentists “logged”].

Thursday, July 25, 2013

WTAE Pittsburgh Reports on Senate Investigation of Small Smiles Dental Clinics and Reachout Healthcare America

Senate report says Small Smiles dental clinics wasting taxpayer money
Report: No more Medicaid for Small Smiles

Jul 24, 2013


PITTSBURGH —A blistering report says taxpayer dollars are being wasted at a national chain of dental clinics, including one in Pittsburgh

The Senate began its probe following a Channel 4 Action News investigation into the Small Smiles dental clinic.

The clinics have been accused of performing unnecessary procedures on children to get more taxpayer money from Medicaid.

In its report, the Senate Finance Committee says that is still going on and so Small Smiles should not get more money from Medicaid.

None of the families interviewed outside the Small Smiles clinic in East Liberty were aware of the Senate report.

After learning of the report, the Bagley family had second thoughts about the surgery being planned for 5-year-old Christopher.


Read more and see video report, along with other investigations of Small Smiles by WATE  here:

Tuesday, July 23, 2013

Senators Max Baucus and Chuck Grassley issue 1,500 page joint report calling for corporate Medicaid dental clinics to be ousted from the program

Today, Senators Baucus and Grassley issued a 1,500 – 1517 pages to be exact — page report on claims I’ve been making here on Dentist The Menace for nearly 6 years. The report includes 66 exhibits.
Center for Public IntegrityThe story accompanying the release of the Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program can be found at The Center for Public Integrity, here.  In David Heath’s story, he reports the new owners Small Smiles Dental Centers state the following:
only five of the 20 inspection reports mentioned in the Senate report fell under its watch.”
…"We've taken action to help CSHM improve its quality of care and management,"
…“The new team immediately initiated an aggressive turnaround effort premised on patient care, clinical excellence and regulatory compliance,” the company said.
Well, that’s nothing to be crowing about, since the “new management”  only legally acquired the company 13 months ago putting a guy by the name of David R. Wilson in charge. That was in June of 2012, (13 months ago) so 1/4 of the inspections mentioned in Bacus/Grassley report took place under their watch. This is not a good record in my opinion — heck it’s as bad if not worse than the Michael Lindley/Al Smith or DeRose Family regimes.  Nor it does it demonstrate anything close to “an aggressive turnaround effort on patient care”.  What it does demonstrate, however, is “business as usual”. 
CPI also reports twice last year the OIG threatened to shut Small Smiles out of the Medicaid program.
“Twice last year the HHS inspector general threatened to exclude Small Smiles from the Medicaid program. But in a letter to Grassley and Baucus, Inspector General Daniel R. Levinson said Small Smiles fixed the problems by selling the Manassas clinic, paying a $100,000 penalty and addressing other concerns.”
Kids and Family Dentistry - Manassas LogoNow, did CSHM actually “sell” the Manassas, Virginia clinic?  That is highly suspect!  A guy out of Idaho left his own practice and moved his entire family to Virginia and slapped his name on the place, calling it Kids and Family DentistryFamily and Kids Dentistry - Pueblo LogoCoincidently, at the exact same time, the Small Smiles flagship clinic in Pueblo, Colorado changed it’s name to Family and Kids Dentistry, making the “owner” the same guy who was  the lead dentist working for Small Smiles at the time.  (Logos have a odd resemblance about them, don’t they?)  Anyone taking bets on whether the DeRose family — founders of Small Smiles —are somehow still involved with these two clinics?
As for the $100,000 penalty, that didn’t even cover 1/2 of the amount scammed in the x-ray scam in just one Colorado Small Smiles.  What would add insult to injury is it was probably on a payment plan, like the $24 million settlement in 2010.
The Bacus/Grassley report includes independent monitor reports on Small Smiles Phoenix, Arizona, Manassas, Virginia, Oxon Hill, Maryland and Youngstown, Ohio and others.  Small Smiles signed a Corporate Integrity Agreement with OIG in January 2010 agreeing to 63 pages of terms and conditions, including self-reporting.  Of course the “independent monitor” can only report on what they find.  But what about what they don’t find? 
I’ve not come close to reading the entire report just yet, but so far I’ve not read anything about the $200K x-ray scam in one of Colorado clinic that was NEVER self-reported, or the fact that a corporate staffer took the necessary Continuing Education courses to get the lead dentist in Mishawaka, Indiana credentialed in Indiana, making her effectively non-licensed to practice in Indiana to this very day or a host of other illegal activities going on behind the closed doors at Small Smiles Dental Centers and Church Street Health Management (CSHM). I doubt I find these things in the report, but you can find them here if you look.
It’s scary to think state dental boards and state Medicaid programs have not only turned a blind eye to the child abuse, but promoted and encouraged it.  Those of us following this industry also know this is just the tip of the iceberg. 
More on this eye opening report in the coming days.  In the meantime, I encourage everyone to read The Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program and evidence attached by clicking here .

Monday, March 25, 2013

Dr. Bicuspid reports on Arizona Mobile Dental Bill HB 2426 and ReachOut Healthcare America

At the end of their story are consent form examples.

Arizona bill would increase oversight of mobile dental services
By Donna Domino, Features Editor

Dr.-Bicuspid4March 25, 2013 -- Arizona is considering a bill designed to provide more oversight of mobile dental service providers who provide prophys, irreversible procedures, and other dental treatment for children at the kids' schools. 

State Rep. Doris Goodale (R-District 5) has introduced HB 2426, mobile-units_thumb2which would require double parental notification before a mobile dental unit can provide treatment to children: one for routine cleanings and sealants, and a second for irreversible procedures such as restorations or extractions.

Lee Weinstein, DMD, a Scottsdale pediatric dentist and a member of the Arizona Dental Association who helped write the new legislation, said efforts to increase oversight of mobile dental providers gained momentum following complaints by the parents of Isaac and Joel Gagnon, who received dental treatment at their school in 2011. Four-year-old Isaac was given two pulpotomies and two stainless steel crowns, and his brother Joel received an "excessive" number of x-rays.

Saturday, February 23, 2013

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

smallsmilesFebruary 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”. 

Sunday, January 13, 2013

Sentinel Capital Partners has played big role in DSO cancer spreading across the states

In an article dated January 4, 2011, AltAssets published a story about Sentinel Capital Partners.  It had been announced Sentinel Capital had acquired Chase Doors on the same day it unloaded ReachOut Healthcare. If I remember correctly this is where Morgan Stanley stepped in, with the help and assistance of R. Kirk Huntsman. 

As what usually happens in these type of things, a little history is given; that is where the bodies are found buried.

January 4, 2011


Lower mid-market private equity firm Sentinel Capital Partners has acquired US door manufacturer Chase Doors, on the same day that it announced the sale of dental support service ReachOut Healthcare America.

In both cases, financial terms were undisclosed.

Chase Doors, founded in 1932, produces specialty door systems employed in a variety of industrial and commercial settings including corrosion-resistant doors used for hazardous material handling; cold storage doors used in walk-in freezers and refrigerators; double impact traffic doors used in supermarkets and restaurants; and strip and roll-up doors used in warehouses.

The company’s revenues are evenly distributed across new construction, remodeling and replacement, and maintenance in the retail, industrial, pharmaceutical, food processing and markets.

“One of Sentinel’s areas of focus is branded, niche manufacturing businesses,” said Scott Perry, a vice president at Sentinel.

“Our previous investments in the niche manufacturing sector have given us a keen understanding of how to foster growth for businesses like Chase and financial guidance that positions our team to enhance Chase’s current market position while continuing to grow.”

New York-based Sentinel’s investments in other specialty niche manufacturing businesses include pressure regulator provider Engineered Controls International, industrial lubrication equipment maker Alemite, and Fasloc, which produces roof support systems used in underground mines.

  • ReachOut, which the firm has just sold, provides a diagnostic, preventative, and restorative dental services to underserved children in schools and foster programs, the aged and disabled in residential facilities, and to US Army National Guard units.
  • Sentinel made its initial investment in the company in 2007 in partnership with its two founders.
  • In 2008, ReachOut acquired its largest competitor, Mobile Dentists, acquiring Georgia-based Help A Child Smile in early 2010.
  • Today, (January 2011) ReachOut operates in 25 states and provides dental care to more than 425,000 underprivileged children, seniors, and military personnel each year.

“It has been extremely rewarding to work with the ReachOut and Mobile Dentists management teams,” said David Lobel, managing partner at Sentinel.

  • “ReachOut is now firmly established as a powerful growth platform that delivers critical dental care to large and underserved segments of the population. We are proud to be affiliated with a business that not only has done well for its investors, but also provides a greatly needed healthcare service.”
  • “We are fortunate to have enjoyed considerable success investing in the dental industry and will continue to seek new dental investment opportunities in the future,” said Paul Murphy, a partner at Sentinel.
  • In the past, Sentinel has taken stakes in Castle Dental Centers, sold to Bright Now! Dental in 2004, and Metro Dentalcare, sold to American Dental Partners, in 2007.

Friday, January 04, 2013

WARNING to Scotland County, North Carolina Health Department

Apparently Scotland County, North Carolina and it’s Health Department hasn’t gotten the memo about Reachout Healthcare America, Morgan Stanley Private Equity and Elliot P. Schlang, DDS.

What I’m concerned about is this “partnership” between Reachout Healthcare America (RHA) and the Scotland County Department of Public Health. Teaming up with an income motivated private equity firm and ANY department of public health seems to be a VERY bad idea!

Someone needs to warn the county about who they are jumping in bed with. At the very least they should be warned about the astronomical number of  cancer causing X-Rays these children will be subjected to; you know the staff has to make that daily production goal!



Mobile dental clinic returns

by Staff report

01.04.13 - 12:01 am

The mobile dentist program — Smile North Carolina — will return to Scotland County three times over the next three months.

The Scotland County Department of Public Health will host the first session on Jan. 9. The dental team will be at the county health department AT 1405 West Blvd. in Laurinburg from 9 a.m. to 12 noon and 1 to 3 p.m.

There are also visits planned for Feb. 13, and March 12.

Children from 12 months to 18 years of age are eligible for the preventive dental services provided by this program.

“The Smile Program will continue to collaborate with our agency to provide dental care to children under 18 years old” said Cardra Burns, WIC program director at Scotland County Department of Public Health.

Smile North Carolina teams include a licensed dentist and registered dental hygienists. The team will provide and complete all paperwork as a state mandated requirement for the dental exam and provide permission forms in English and Spanish and letters to the parent for every child.

Dental referrals are provided by Smile North Carolina if additional dental work is needed.

Most dental insurances, including Medicaid, cover 100 percent of the services that are provided by Smile North Carolina. For those children without dental coverage, charity care services are available with a parent’s signature on a charity care application. No proof of financial status is asked, health officials said.

Smile North Carolina has been coordinating dental care to children, families, and communities for almost 15 years and is OSHA and HIPAA compliant.

Burns said about 132 Scotland County children have received dental care since June 2012.

Tuesday, December 04, 2012

Morgan Stanely’s Reachout Healthcare Mobile Dental Clinics continue breaking new rules put in place to protect children from their abuse of children

I realize it’s hard to believe someone, i.e. R. Kirk Huntsman, convinced Morgan Stanley that driving up to schools, sending criminally incompetent dentists and employees inside to zap them with as much radiation as possible, restrain children and perform dental procedures with or without consent, then bill the taxpayer was a great idea. But it happened.

Below is an update on the lawsuit filed by Darren and Stacey Gagnon on behalf of their son, who was traumatized by Reachout Healthcare mobile dental clinic employees in Arizona. Imagine the stuff that was too “hot” to include in the following piece.

WATCH this video!

Don’t forget to comment here and over at My Fox Phoenix here

PHOENIX – December 3, 2012

myfoxphoenixAs we first reported back in June, a mobile dentistry operation is being sued by an Arizona family. They allege their special needs son received unnecessary dental work at school.

Tonight, we revisit the Gagnons, to see how their son Isaac is doing, and update a case that may have already forced the state to make changes in the way dentists do business.

The first time we met the Gagnons, Isaac was kept from our cameras because they might scare him.

This time, we got a chance to watch Isaac color a picture for his friend's birthday party.

Isaac gets night terrors after what happened to him.

"He was diagnosed with post-traumatic stress disorder… he was a very fragile emotionally child in the first place," says mom Stacey Gagnon.

Fragile in the first place because Isaac was adopted after surviving severe shaken baby syndrome.

"He was horribly injured as an infant including five skull fractures."

But Isaac had come a long way with the Gagnons.

"We saw this little boy emerge who loved tractor trucks and run and play in the dirt."

That ended about a year ago.

"October 4th, Isaac was seen by a dentist at school," says dad Darren Gagnon.

A dentist from Big Smiles, a part of Reachout Healthcare America, treated Isaac inside his school's art room.

"He says you know the dentist man got me… we didn't know what had happened."

Reachout paperwork in Isaac's backpack showed the boy had been given two pulpotomies - or baby root canals - and 10 X-rays. Something his parents say they never approved. Isaac's mother called Reachout for an explanation.

"They told me it was a training error on their part," says Stacey.

Everything the Gagnons allege is part of this lawsuit they filed against Reachout, Big Smiles, and two dentists.

It alleges among other things, battery, fraud, intentional infliction of emotional distress and racketeering.

"We found out from the school they had actually held Isaac down for somewhere in the neighborhood of 40 to 45 minutes, that they physically restrained him to do the work on him because obviously he was in a lot of pain," says Darren.

The two dentists named in the lawsuit include Doctor Ralph Green who works at Reachout Corporate offices in north Phoenix -- and Doctor Alvin J. Coon, who performed the work on Isaac.

Wednesday, September 12, 2012

Inside Edition airs the Isaac Gagnon story and the dangers of mobile dental clinics.


msMorgan Stanley, the true backers of ReachOut Healthcare America and their nasty mobile dental dungeons have been on this site several times the last few days. So has their PR people. Are they worried?

Shocked is more like it. I’m told their attorney’s about flipped, when they saw their RHAemployee, Dr. Alvin Coon, DDS attempt to hit the reporter with his car. I guess someone failed to mention that to them. Wonder what other surprises are in store.

Features the parents of little Isaac and the nightmares which haunt him; the mean dentist who “got” Isaac - Dr. Alvin Coon attempting to run over the reporter: and an Interview with the Gagnon family’s attorney, James Moriarty.

If you have inside information, are an ex-employee - like the one in this story- who wants to stop this child abuse or a parent whose child has suffered at the hands of these Mobile Dental vans, please email me. Surely we can stop this child abuse together.

Here is Inside Edition’s report:

INSIDE EDITION Investigates Mobile Dentistry
Aired September 11, 2012

Inside EditionIt sounds like a good idea - mobile dentists sent to schools to provide dental care for needy children in classrooms and school parking lots. But some families are now crying foul, saying their kids were harmed by dentists drilling for dollars.

Darren and Stacey Gagnon say their four-year-old son Isaac was given two baby root canals and two steel crowns by a dentist bigsmilesscheduled to visit Isaac’s school after the school contracted with a company called ReachOut Healthcare America.

What’s worse, say the Gagnon’s, is that the dentist, Dr. Alvin Coon (who they never met) performed the operations without their consent in of all places - the school’ art room in Camp Verde, AZ.

“I couldn’t believe that they were doing these procedures in a classroom,” said Stacy Gagnon.

She also says Isaac was never given any anesthetic or medication to numb the pain.


Sunday, September 02, 2012

Dental care in America: A study in austerity, neglect and profiteering


Dental care in America: A study in austerity, neglect and profiteering

By Gary Joad
1 September 2012

A Frontline production on the Public Broadcasting System (PBS) aired in June documented the painful and ill experiences of millions of working class families and their children, the disabled and poor, and retired persons as they seek dental care in the United States.

In the opening scene of “Dollars and Dentists,” hundreds of people with jaw and tooth pain form long lines in the early morning freezing rain of southern Virginia, seeking relief from a volunteer dental clinic. Most patients declare on camera that they are often too sick and sore to eat, and that they are compelled to live with pain every hour of their lives.

As the clinic’s Dr. Terry Dickenson states at the program’s beginning, “Gas, food, and rent compete with dental care for the dollars these persons have.”

Washington, D.C. resident Vanessa Nations, 31, reported that she had been significantly ill with dental and gum infections for many years, until her problems became so severe that she needed all her teeth extracted. She commented, “I feel like little bits of poison are killing me.”

She could not eat sufficiently, and therefore could not maintain a normal weight. Virtually all her teeth were chipped, broken off, and discolored. Poignantly, she brought a smiling teenage photo of herself to show the dentists how she wanted to look again, as they planned the removal of her ruined teeth and the manufacture of her dentures.

Tuesday, August 28, 2012

Reminding the public about ReachOut Healthcare America - Big Smiles Mobile Dental Clinics - One More Child Foundation

School is in, and the ReachOut Healthcare America mobile dental vans are hitting the unsuspecting public schools - which is like turning pedophiles by the dozen loose in each school they visit.
They go by lots of names, including Michigan Mobile Dentists,  Big Smiles of Texas, Big Smiles of (name of state) and in Georgia it's, "Help  A Child Smile".

If the above van is at a school, you can rest assured children are being overtreating and over x-rayed and you should run to the school and jerk them out immediately! It does not matter if you signed the form your child brough home or not, they WILL and DO treat children anyway!

The clinics in Georgia are operated under Dr. Mark Shurett, DDS. Not only is the website registered to ReachOut Healthcare American, so is Dr. Shurett's general dentistry website - Shurett Dental Group. 

Don't miss the forms Dr. Shurett's "forms", exactly like Big Smiles and others put out by ReachOut Healthcare America. If you need confirmation, go to and check out who owns these websites.

But this is what you will find:
Roberts, Glen
2550 W Union Hills Drive # 202
 Phoenix, Arizona 85027
 United States
 Stay on your toes, parents - Below are the stories about this nasty place on wheels.
Arizona Republic -Mobile Dental Clinics Drawing Scrutiny  - which ran on Saturday August 18, 2012.

Story on May 2012 by Bloomberg and June 2012 by FRONTLINE

The Gagnon Lawsuit filed against Dr. Ralph Green, Dr. Alvin Coon and ReachOut Healthcare America.

Dental Abuse Seen Driven by Private Equity Investments

 Sydney P. Freedberg in Miami at
May 16, 2012

Isaac Gagnon stepped off the school bus sobbing last October and opened his mouth to show his mother where it hurt.

She saw steel crowns on two of the 4-year-old’s back teeth. A dentist’s statement in his backpack showed he had received two pulpotomies, or baby root canals, along with the crowns and 10 X-rays -- all while he was at school. Isaac, who suffers from seizures from a brain injury in infancy, didn’t need the work, according to his mother, Stacey Gagnon.

“I was absolutely horrified,” said Gagnon, of Camp Verde, Arizona. “I never gave them permission to drill into my son’s mouth. They did it for profit.” 

“I was absolutely horrified,” said Gagnon, of Camp Verde, Arizona. “I never gave them permission to drill into my son’s mouth. They did it for profit.” 

Isaac’s case and others like it are under scrutiny by federal lawmakers and state regulators trying to determine whether a popular business model fueled by Wall Street money is soaking taxpayers and having a malign influence on dentistry. 

Isaac’s dentist was dispatched to his school by ReachOut Healthcare America, a dental management services company that’s in the portfolio of Morgan Stanley Private Equity, operates in 22 states and has dealt with 1.5 million patients. Management companies are at the center of a U.S. Senate inquiry, and audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry. 

Allegations like Gagnon’s “are not representative” of the more than 500 cases handled by ReachOut affiliates in Isaac’s school district, said Mickey Mandelbaum, a company spokesman.

Private-Equity Purchases

ReachOut is one of at least 25 dental management-services companies bought or backed by private-equity firms in the last decade. Dentists contract with the companies for marketing, scheduling, staff recruitment, supplies and other services. The companies account for about 12,000, or 8 percent, of U.S. dentists, according to Thomas A. Climo, a Las Vegas dental consultant. 

Some of them have been riding a boom in Medicaid outlays on dentistry, which rose 63 percent to $7.4 billion between 2007 and 2010, outstripping the 4.9 percent growth in other dental spending. ReachOut and several of its private equity-backed rivals seek patients like Isaac Gagnon, who are covered by Medicaid, the federal-state insurance program for the poor and disabled. 

On May 2, All Smiles Dental Center Inc., a management company owned by Chicago-based Valor Equity Partners, filed for bankruptcy protection. Its hand was forced in part by a Texas Medicaid action cutting off payment to some of its clinics because of allegedly “excessive” and “inappropriate” orthodontic care, according to an All Smiles executive’s affidavit included in the filing. All Smiles was part of a state audit in which 90 percent of Medicaid claims for orthodontic braces were found to be invalid because they weren’t medically needed, according to Christine Ellis, one of the auditors.

Another Bankruptcy

The All Smiles collapse followed another bankruptcy filing in February by Nashville-based Church Street Health Management LLC, which cited the costs of defending itself against lawsuits and investigations. Church Street is owned by Arcapita Inc., Carlyle Group LP (CG) and other private equity firms and affiliated with the Small Smiles network of dental clinics. 

U.S. Senate investigators are examining whether ReachOut, Church Street and its affiliated clinics have overbilled Medicaid, according to Senate documents and people familiar with the matter. Another company under Senate scrutiny is NCDR LLC, which manages 130 Kool Smiles clinics, these people say. NCDR is owned by Friedman Fleischer & Lowe, a San Francisco buyout concern.

‘Assembly Line Service’

Church Street may be abusing patients, “grossly overcharging the United States government in Medicaid reimbursement claims,” and focusing “more on achieving self- imposed quotas via assembly line service than proper patient care,” U.S. Senators Charles Grassley and Max Baucus told the company in a November letter copied to Carlyle co-founder William E. Conway Jr. Grassley, an Iowa Republican, is Ranking Member of the Senate Judiciary Committee. Baucus, a Montana Democrat, chairs the Finance Committee. 

One broad issue in the inquiry is whether the management companies merely provide services to dentists, or are breaking the law by directing care, according to people familiar with the matter and letters the Senators sent to state regulators. State laws broadly say only licensed dentists or firms they own can practice dentistry.
Church Street “respects the Senate’s important oversight role” and has provided information about improvements in the quality of care over the past five years, said Don Meyer, the company’s spokesman. He said the bankruptcy isn’t affecting patients. 

Reachout’s Mandelbaum declined to comment on the Senate inquiry. NCDR, whose Kool Smiles affiliates had 2 million patient visits last year, is “committed to an open dialogue with regulators and legislators,” said Geoffrey Freeman, a spokesman.

Underserved Children

ReachOut, NCDR and Church Street do not make care decisions or own dental practices, according to their spokesmen. Each company said it is dedicated to helping underserved children get dental care. 

After years of complaints that the poor were being deprived of such care under Medicaid, public pressure and class-action lawsuits opened the floodgates. Texas’s Medicaid dental outlays tripled to $1.24 billion between 2007 and 2010, as fees were boosted so more dentists would accept patients. Indiana, Connecticut, Maryland and Tennessee also boosted reimbursements. 

At the same time, young dentists with education debt sometimes topping $300,000 “can’t get the loans they need to start their own practices,” said Bryan J. Shanahan, past president of the Arizona Dental Association. “So they look for work in a corporate setting where they get immediate cash flow.”

Working ‘School Hours’

Dental management firms can deliver patients and a six- figure income by sending teams to schools where they can treat Medicaid-eligible students in volume -- as many as 30 children in one visit. A ReachOut recruiting ad last year promised “15+ patients/day” and “$120K/year (+ bonus opportunity)” by working “school hours 1-5 days per week.” The ad appeared on the website of the University of Detroit’s dental school. 

The private equity industry has stepped up its investment in dental management in the last five years partly because health care was one of the few areas that grew through the recession, said M. Alec Parker, executive director of the North Carolina Dental Society

Wall Street buyout firms have also been attracted to dental practices because they are less regulated than physician groups, according to Sandy Steever, an editor with Irving Levin Associates in Norwalk, Connecticut, which tracks health-care transactions.

Cottage Industry

Dentistry is a fragmented, “cottage” industry ripe for management services, said Robert Fontana, chief executive officer of Aspen Dental Management, owned by Leonard Green & Partners, a Los Angeles private equity concern. Fontana and other industry executives said they see no evidence that private equity investment lowers the quality of dental care. 

Texas is investigating dozens of cases where dentists, including affiliates of management companies, may have done unneeded work or billed Medicaid for undelivered services, according to spokesmen for the attorney general and other state agencies. 

Investigators are looking at allegations that dentists placed crowns on children needing only less-expensive fillings, or put needless braces on 12-year-olds with baby teeth -- at taxpayer expense, said Joy Sparks, general counsel for the Texas State Board of Dental Examiners. 

The investigation includes cases involving Kool Smiles and All Smiles, according to Stephanie Goodman, a spokeswoman for the state Health and Human Services Commission, which oversees Medicaid.

‘Unbelievable’ Fraud

Ellis, a Dallas orthodontist, testified in Congress last month that the “flagrancy of the fraud” she found in audits she performed for Texas Medicaid “is truly unbelievable,” with only 10 percent of the paid claims she reviewed actually qualifying for Medicaid coverage. 

Texas “has gained a lot of fraudulent orthodontic providers, including many private equity owned dental clinics engaged in the illegal practice of dentistry,” Ellis told the U.S. House Committee on Oversight and Government Reform. 

Ellis audited All Smiles claims for the state from 2007 through 2011, and found “overutilization” of Medicaid benefits before and after Valor bought control of the firm in 2010, she said in an interview.

‘Credible Evidence’

Texas’s Medicaid program has put Dallas-based All Smiles on “payment hold for credible evidence of fraud” and referred the case to the attorney general, said Goodman, the state health commission’s spokeswoman.
Texas inspectors have taken “exception” to 63 of 86 All Smiles orthodontic cases reviewed from 2007-2011, according to Michael Lozich, its chief compliance officer. “We’re going to defend ourselves and contest against these claims,” he said. 

All Smiles and its founder, Richard Malouf, previously agreed to pay the U.S. and Texas $1.2 million to settle Medicaid fraud allegations between 2004 and 2007, without admitting wrongdoing. 

In Michigan and California last year, groups of dentists sued their management company, American Dental Partners, alleging it interfered with treatment decisions only dentists are allowed to make. JLL Partners, a New York private equity firm, completed a buyout of American Dental for about $390 million in February.

Patients Unattended

American Dental refused to replace defective anesthesia equipment, used bill-collection policies that led to “refusal of dental services to patients” and failed to maintain proper staffing levels, the Michigan plaintiff, Redwood Dental Group, alleged. The policies caused patients to be left unattended and their care to be rushed, Mark Bouchillon, Redwood’s president, said in a letter attached to the complaint. 

American Dental, which manages more than 280 dental centers in 21 states, declined to comment. The Wakefield, Massachusetts, firm has appealed a judge’s ruling against its motion to force arbitration in the Michigan case. The California case is under arbitration. In a federal filing in November, the company said it intended to defend itself and its subsidiaries “vigorously.” 

“How is JLL going to generate a return on its huge investment without further squeezing our dental practices financially?” asked Bouchillon, whose group has about 25 dentists. 

After actions taken against affiliates of one management company last year, North Carolina is considering legislation that would subject agreements between dentists and the companies to state approval.

Quota Pressure

The North Carolina Dental Society, which backs the bill, says some management companies bill patients for unneeded care and otherwise operate illegally. Dentists may be pressured to meet quotas and perform more-expensive treatments “instead of focusing on what’s best for patients,” according to a website sponsored by the group. 

Opponents say passage of the measure will drive up costs. The two sides have begun lobbying and TV ad wars. Private-equity players Leonard Green, Court Square Capital Partners, and Levine Leichtman Capital Partners own or back companies that contribute to Alliance for Access to Dental Care, a political committee that has raised $1.1 million to fight the bill, according to state records. They say the management companies usually charge less and accept more types of insurance than private practitioners. 

In California and Arizona, state investigators are examining complaints that ReachOut-dispatched teams billed Medicaid for unnecessary work on children, according to people familiar with the inquiries.

Program Ended

In Nevada, the Clark County School District ended its ReachOut program earlier this year. School nurses had complained about children returning to classrooms in pain after baby root canals and other work, according to Amanda Fulkerson, a spokeswoman for the district, which includes Las Vegas. Derryl Brian, one of the mobile dentists who worked with ReachOut, said they had treated 80,000 children since 2006 with a high satisfaction rate. 

ReachOut’s owners have called the company a “unique” model. In 1997, founders Michael Howell and Daniel Goldsmith started a company to coordinate care to nursing-home residents in Michigan. They expanded to children in schools and by late 2003, were delivering dentistry to homeless shelters, foster programs, group homes and mental health facilities. 

In November 2007, ReachOut received private equity funding from Sentinel Capital Partners, of New York. Under Sentinel, it acquired two rivals and increased its patient size fivefold. Last year, as a holding of Morgan Stanley Private Equities, its dentists saw 488,000 children in 8,700 schools.

Mainly Preventive Work

“Many of these children would otherwise go without even the most basic care,” said Mandelbaum, the company spokesman. ReachOut affiliates mainly clean and perform preventive work, with baby root canals and crowns accounting for less than half of 1 percent of patients, he said. 

ReachOut’s model is built on the premise that low-income parents often don’t have time or transportation to take children to the dentist. So mobile teams pack equipment in large cases, load up a minivan, head to schools and set up in gyms, libraries or classrooms. 

In most states, only a dentist, not a business corporation, can be licensed to control and conduct a dental practice. U.S. Senate investigators are examining whether some dental management companies are actually de facto owners of practices that bill Medicaid, according to letters Grassley and Baucus have sent to state regulators.

‘Embedded’ in Practice

Management companies have “moved from being vendors of services,” such as patient billing, “into increasingly complex arrangements under which some -- not all -- have embedded themselves deeply into every aspect of the dental practice,” said Ken Burgess, an attorney for the North Carolina dental board.
The Big Smiles dentists’ network and others ReachOut serves use “their own professional judgment and discretion,” and share the company’s belief that patients shouldn’t be physically restrained, according to Mandelbaum. 

One of ReachOut’s most-ubiquitous affiliated dentists is Elliot Schlang, who has registered dental practices and licenses in at least 16 states. Schlang said he practices in all of them and travels the country training staff and treating children.
“I work day and night,” he said in an interview. 

Another ReachOut-affiliated dentist is Ralph Green. Arizona records list him as the principal of a dental practice that has the same Phoenix address as the one shown on ReachOut’s website. The website lists Green as ReachOut’s clinical director.

Unnecessary Drilling Complaint

In August 2010, Green’s lawyer appeared before the Arizona dental board to answer a complaint that ReachOut did unnecessary drilling on a Phoenix student’s teeth -- even after the student’s mother, Valerie Davila, told the company she was seeing a family dentist and didn’t need any work. 

The 6-year-old, Sabrina Martinez, suffered “unnecessary pain,'' Davila said. ''Imagine if it was your child.”
There were two children with the same name at the school, and the work was done on the wrong Sabrina Martinez, Green’s lawyer, Jeff Tonner, told the dental board. Although the board agreed that work was done on the wrong child, it dismissed the case, noting Davila had complained about “the business entity,” not a dentist.

Four Teeth Missing

In San Diego, Tina Richardson’s third grader, Alexander Henry, came home in March with four baby teeth missing after a school session with a ReachOut-affiliated dentist that was so painful he “waved his arms frantically,” “pushed everyone off him” and “bled so badly that they had to send him to the nurse’s office,” according to her complaint with the state dental board. Among other things, Richardson said the consent process wasn’t valid. 

Richardson said Alexander had seen a dentist nine days earlier who didn’t recommend any teeth pulling. Although she signed a consent form in September covering many procedures including extractions, she said she didn’t sign another one that came in November seeking permission to take out three teeth. No one from ReachOut called to discuss the proposed procedures, she said. 

The state board is investigating her complaint, according to a letter to Richardson. Gurgen Sahakyan, listed as Alexander’s mobile dentist on a form brought home from school, said “the original consent was signed” and the work was done well. Mandelbaum said ReachOut couldn’t discuss specific patients.

Dentistry Guidelines

American Academy of Pediatric Dentistry guidelines say “oral discussion between provider and patient, not the completion of a form, is the important issue of informed consent.” 

In Arizona, a state investigator subpoenaed the names of children seen by the ReachOut-dispatched dental team on Oct. 4 last year, the day Isaac Gagnon was treated, said Dan Brown, who was then Camp Verde School Superintendent. 

When ReachOut called Stacey Gagnon to tell her the mobile dentist was coming to Isaac’s school, she said she explained that he had seizures and other serious medical conditions. ReachOut was told he could have a cleaning and oral hygiene education, nothing else, according to Gagnon. 

Five weeks later, a ReachOut team in the art room at Camp Verde Elementary took X-rays of Isaac, according to preschool instructor Becky Fordham. When Isaac was moved to a corner of the room, he began to gag, Fordham said.

Kicked and Screamed

He kicked and screamed while several adults held him on the dental table, according to another teacher’s aide, Stephanie Shultz. “The dentist man got me,” Gagnon remembers her son saying. 

The Gagnons said the school identified Isaac’s dentist as Alvin J. Coon Jr., who works with a ReachOut-affiliated practice registered in the name of Green -- the dentist who answered Davila’s complaint in the Phoenix case. Coon and Green’s lawyer declined to comment. 

The root canals were unnecessary and the number of X-rays was “excessive,” according to Bobby Lee Raber, a dentist in Prescott who reviewed the records for the Gagnons. Professional guidelines call for only four X-rays for a child Isaac’s age, Raber said. 

Isaac should have been sedated to numb the pain and not held down, Raber said in a written review. He said he ends treatment and reschedules when children cry, and doesn’t sedate or restrain them without parental consent.

Medicaid Refunded

A couple of weeks after Isaac’s dental visit, Gagnon said ReachOut told her the company refunded Medicaid the fees for her son Joel, who was seen at school on the same day as Isaac. The Gagnons say they didn’t complain about Joel’s examination. 

Darren Gagnon, Isaac’s father, said he received a visit from Robert Linder, a ReachOut regional vice president, about a month after the treatment. Linder apologized that Issac was treated without consent, and said what happened was “not common practice,” according to Darren Gagnon and a colleague who was also at the meeting. 



June 26, 2012


July 2, 2012
Sen. Charles Grassley (R-Iowa) says that his investigators have found evidence of abuses by corporate dental chains treating children on Medicaid.

For months now, Grassley’s staff has been asking questions of three dental chains serving poor children on Medicaid. Each is owned by a private-equity firm. The chains are Kool Smiles, Small Smiles and ReachOut HealthCare America.

“We’re finding that these dental practices, under pressure from owners who are not licensed dentists, have been providing services with the highest Medicaid reimbursement levels more often than less expensive, arguably more appropriate services,” Grassley said.  ”There are legitimate concerns that children are receiving unnecessary care, sometimes in a traumatic way, and taxpayers are paying for it.”

Earlier this week, a joint investigation by the Center for Public Integrity (CPI) and FRONTLINE, revealed that the Atlanta-based chain Kool Smiles’ business model of serving kids on Medicaid has led to complaints that it overtreats children. The company has been accused by regulators in Georgia and Connecticut of overusing expensive stainless-steel crowns to treat small cavities.
Kool Smiles vigorously denies this, saying that it offers quality care to children in dire need. It is the largest Medicaid dental chain with 129 offices in 15 states and the District of Columbia.
Grassley said, “You have dentists under pressure to perform more services than may be necessary — giving a child a crown instead of a filling, for example — because of a bonus payment structure that creates the wrong incentives.”

As reported by CPI and FRONTLINE, one of Kool Smiles’ most controversial practices is its dentists’ heavy use of stainless-steel crowns to restore decayed baby teeth. Crowns are more profitable than fillings for dentists, because they can charge more for them. Kool Smiles provided analysis intended to show that it doesn’t overbill Medicaid but offers services at a lower cost than other dental providers.

Grassley said the problem was rooted in the structure of these chains, saying that it claims that dentists own the practices but in reality they do not have control.

“These ‘owner dentists’ are effectively ghost owners who maintain none of the traditional aspects of ownership of their operations, allowing the corporate investors to have control over clinical operations,” Grassley said.

The senator is also looking at Aspen Dental Management, another corporate dental chain owned by private-equity firms. Aspen Dental does not accept Medicaid, but Grassley said there are concerns that “the company promotes unnecessary treatment plans with exorbitantly expensive credit arrangements.”

CPI and FRONTLINE also investigated Aspen Dental and found that its business model of serving patients who cannot afford a dentist had led to complaints of overtreatment and loading patients who cannot afford it with debt.

Aspen Dental denies this. It says it offers services to people that other dentists ignore.
Sen. Grassley said he expects to issue a staff report on his findings on companies that serve children on Medicaid. His investigation into Aspen Dental is ongoing.


Jeff Tonner, the attorney representing Dr. Ralph Green, of ReachOut Healthcare America had this to say on Dentaltown after the PBS story:

June 26, 2012 Dentaltown (registration required)
At Howard's (Farran) email invitation, I watched the PBS broadcast, "Dollars and Dentists," last night. Like most "investigative" reporting, I found the analysis flawed. Let me illustrate with an example.

Suppose three companies manufacture toasters. The first corporation produces one defective toaster for every 100 assembled, the second 1 per 1K, and the third 1 per 1M. Any reporter can locate a few dissatisfied customers for the third company, parade them on TV, and cast the company in a bad light. The best can be made to look like the worst.

All dentists, or dental companies, make mistakes. The true questions is - - how often do these errors occur compared to their peers. This is the analytical component that most new shows don't/won't present. To be fair, such data often can be difficult to obtain. I would argue that without a baseline, the subject is not newsworthy; however, we all know smut sells. Look at the program title. Reading only it, the viewer knows the slant before viewing the content.

The end of the program highlighted an elderly lady who financed $8K for dentures through Care Credit. I am sorry that she had buyer's remorse, but where is the personal responsibility? The program noted her total payments would equal $12K. So would an $8K dining room set purchased on credit. That's how interest works.

I stopped watching 60 Minutes years ago, because the exceptions were showcased without any reference to the majority. IMHO, it elevated "sensationalism" to an art form. My bottom line, the show offends my sense of fairness and decency.

Rarely but occasionally, I represent a DDS associated with some sensational allegations. When the TV stations contact me, I offer an interview but only if it is live. I don't trust them to edit fairly. They always refuse. Surprised?

ReachOut Healthcare America - Missouri 2011 Filings list true owners and directors