Showing posts with label Small Smiles. Show all posts
Showing posts with label Small Smiles. Show all posts

Monday, November 18, 2013

Judge Orders Retrial for 1st Small Smiles Malpractice Case in New York–“Creepy” AIG Attorney Stalks Jurors

Syracuse, NY -  In October a verdict for the defendants was handed down by the jury in the 1st of 33 malpractice cases against Small Smiles and their dentists slated to be heard in New York courts.

Just after the verdict, the jury informed the judge they were stalked throughout the 15 day trial by a “creep” and “sleazy” guy who turned out to be a New York attorney by the name of Scott Greenspan.  Greenspan was hired by malpractice insurance carrier National Union Fire Insurance Company, a division of AIG .

Now, “upon examination of the facts”, Judge Deborah Karalunas. has ordered a new trial, concluding “…that Mr. Greenspan made improper contact with the jury.”

In her November 18, 2013 decision, Judge Karalunas finds AIG attorney Scott Greenspan’s conduct “violated the sanctity of the jury, raises ground for suspicion that the decision was found on something other than the evidence and was prejudicial and likely to influence the verdict.”

“This is not a matter of an isolated elevator conversation, cake for juror appreciation day or expression of condolence.  This is a case where jurors over a 15-day period believed that they were stalked, videotaped and closely monitored by a person they believed worked for the defendants,” says Judge Karalunas.

“This is a case where jurors performing their civic duty were made to feel bothered and scared.”

Under questioning by Judge Karalunas, one juror said:

“He followed us everywhere. When we would go to lunch, he’d follow us to where we were going.  One day we had an hour and 15 minutes, a little extra time, so we walked down to the Armory Square to Blue Tusk.  And I told the other jurors, this guy is following us everywhere.  So after the third time I saw him, I said look behind you, that’s what I’d say to them, and he would always be there.

“But when we would go on the elevator, he would always be there.  when we got outside, we would go to have a cigarette right out front, he’s always be standing close by.  When we got back on the elevator to come up,he was always there.”

‘…the only times we did not see him out of the whole time was once we went to Ale and Angus and once we went over to The Mission and we didn’t see him there.”

The juror told Judge Karalunas that Mr. Greenspan was in the elevator “at least half the time, if not three quarters of the time.” 

So there ya have it.  A new trial and I would guess that National Union/AIG would need to pick up the tab for this. Now, wouldn’t it have just been easier to write this child a check for all the hell he’s been put though?!  Just saying…

Small Smiles Dental Syracuse Bohn Malpractice New Trial Decision

Friday, October 18, 2013

Small Smiles Dental Centers Release Statement RE: New York Malpractice Case #1

image

 

 

 

 

 

 

 

 

 

 

 

Sorry, there is no mistake or confusion. It's the one and the same.  Creative financing and a few (very few) corporate heads rolling does not a completely different company make. Good try.

I suspect in the future we will see New FORBA and NEW NEW FORBA side by side in court just as we have Old FORBA and New FORBA today.

A dead fish by any other name still stinks.

PS. there is issue with jury being "stalked" so verdict is not set in stone.

Friday, August 16, 2013

More non-compliance issues and attorneys plan to blame the children for the abuse suffered by Small Smiles dentists

DTM Avatar-TransparentI have the transcripts from the hearing held in Syracuse on Wednesday (14 Aug 2013) and right out of the gate there seems to be a problem right out of the Nashville office with “compliance”.  I’m sure everyone is shocked, right?

Guess who seems to have a problem with it, compliance, that is?  It would be Ms. Linda Zoeller.  What is the problem you ask?  She is having problems “complying” with a court Order issued several months ago.  (I know, stop laughing.)  Of course she is having trouble.  I know, I know, they don’t understand “comply” “compliance” or any other form of “following the rules”.  Yes, I know, Zoeller is the one who files the thousands of falsified documents for the fake owners and yes, I know she is the “keeper of the rubber stamps” (rubber stamp signatures of “owner dentists”), so of course she is not going to be forthcoming in anything she does.  Non of these folks are, they believe to their core laws, rules, standards and guidelines do not apply to any of them!  And frankly, from what I’ve seen so far, they are right; no one makes them follow any rules.

Well, apparently the folks in Nashville are still trying to hide evidence, and Zoeller is assisting in that endeavor.  (Stop it!  I know you are in tears laughing…  lol).  Zoeller issued an affidavit a few days ago and the attorneys, nor the judge can figure out if she (Zoeller) is saying she is finally in compliance with the court’s Order or not in compliance.  Just from my experience, I’m going with “not”. 

Amazingly Zoeller is having problems producing the performance reviews and and evidence on how they disciplined the dentists who didn’t meet the financial goals of the company.  I can’t imagine why they would want to hide that information!  (sarcasm)  You know they actually sent some files with blank performance review sheets in them!  I take that as a big ole F you!

If I were any of the dentists on trial, I would certainly want them shown to the court.  But I guess before that, those dentists have got to stop with the bullshit singing the corporate song and start worrying about saving their own asses.  Have the dentists not realized yet, these attorneys do NOT have their best interest at heart! 

Zoeller  is one old heifer I’d love to see on the stand and under oath, with a special perjury officer standing beside her.  Or, maybe one of those bark collars that shocks her ass every time she lies.  Oooo…what about a lie detector projected on a screen for the jury to see as she is asked questions.  Gosh, I’d buy a ticket for a performance like that, wouldn’t you?  Yeah, I know we can’t do that, but it sure would be fun.  One this is certain, she would likely blow a lie detector machine in about the first 3 minutes or less. 

Anyway, they have been trying to hide this intel for almost a year,(ok, since the beginning of time)  still no one can  figure out if Zoeller is saying she has produced them all or not.  I have a pretty good idea, don’t you? 

Zoeller basically says she is over worked and they are short handed and in the past year hasn’t had time to pull any files.  LMAO!  Zoeller says she is working 80 hours a week.  Well, damnit, I’m close enough to check that out.  Just saying…

Anyway, the judge plans on issuing an “adverse inference” sanction and is going to require Zoeller  to be at the hearing to answer some questions.  Ooo, I might have to make this one. 

The judge says, “…clearly, my view, based on in large part Miss Zoeller’s affidavit about the efforts or lack of efforts that were made, is that an adverse inference is appropriate here.” 

“… I do think that the failure to produce was willful.”

“…it is very clear from Miss Zoeller’s affidavit that they didn’t take seriously this, the obligation to preserve these records, to obtain and preserve these records during the course of the litigation.”

Thursday, August 15, 2013

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

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

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

Small Smiles Dental Centers NY Malpractice Defendants are:

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.” 

Sunday, July 28, 2013

Corporate dentistry criticized for unethical practices, unnecessary procedures

Anniston Starby Eddie Burkhalter
eburkhalter@annistonstar.com

Jul 28, 2013

When Quintoya Seawright’s 3-year-old daughter, Destiny, chipped a baby tooth in November 2010, the young mother took her to the Small Smiles clinic in Montgomery. Quintoya, 25, would end up taking her daughter to the clinic four times that month.


On the last visit on Nov. 9, her daughter was strapped to a board for an hour while the dentist struggled to place two stainless steel caps on baby teeth while her daughter screamed and struggled, saying she could still feel it, the family said.
But without much money, the young mother had to rely on Medicaid to pay for her daughter’s care. Small Smiles specializes in treating children eligible for Medicaid. The company operates another clinic in Dothan.


The large dental chain is owned by a private equity firm and is managed by Nashville-based CSHM LLC. A report released by the U.S. Senate Finance Committee last week claims Small Smiles and clinics like it are motivated by profit, often performing unnecessary procedures, and should be removed from the Medicaid program.

The report also says the clinics are operating in violation of laws in 22 states, including Alabama, that ban anyone other than a licensed dentist from owning a practice. The report states that CSHM actually owns and operates the clinics, and not the “owner” dentists the company enlists to skirt to get around those state laws.

Quintoya said she was never allowed to go back with her daughter to watch the procedures at Small Smiles, but the 3-year-old girl’s grandmother, Sophia, demanded she be allowed on the girl’s last trip.


Destiny began pulling at her mouth, so workers strapped her arms and legs to the board, then the dentist struggled for an hour to place the two caps on the tiny baby teeth while Destiny “kept saying she still felt it. He said, ‘No. She’s numb. It’s just the noise,’” said Sophia.


“Her heart was just beating so fast,” Sophia said. “The lady was holding her head down and was trying to get her to open her mouth by squeezing her nose.”
Destiny had a total of five stainless steel caps placed on baby teeth over four visits. One cap fell out along with the tooth a couple weeks later. Quintoya said she never heard the dentist say her daughter had cavities in those teeth, but he said the caps would help prevent them from forming.


“I’m not sure if it was a necessity to have all those silver things in her mouth,” Sophia said.

Read more: Anniston Star - Corporate dentistry criticized for unethical practices unnecessary procedures

Thursday, July 25, 2013

Anniston Star reports on Small Smiles and Aspen Dental Operating in Alabama

Don’t miss this is an in-depth report. Mr. Burkhalter asks some hard questions, the answers didn’t surprise me.  Standard responses expected. 
“We didn’t do it” 
“We didn’t know it” 
“It’s not our problem”

Alabama dental clinics operating illegally, Senate report says

by Eddie Burkhalter
eburkhalter@annistonstar.com

07.25.13 - 08:04 am

Anniston Star Alabama Report July 24, 2013Several Alabama dental clinics are operating in violation of state law, and are putting profits before patient care, according to a report released this week by the U.S. Senate Finance Committee.


Those clinics are performing unnecessary procedures to pay the corporate investors that own the clinics, the report states. The report recommends that state and federal agencies end that practice by enforcing existing laws.
The 1,500-page report, put out by Sens. Charles Grassley, R-Iowa, and Max Baucus, D-Mont., marks the end of a two-year investigation into the practice of corporate dentistry by the staff of the Senate’s Committee on Finance.


Among the companies investigated was Aspen Dental, a nationwide chain of dental clinics that is opening an office in Oxford this year.
Small Smiles dental clinic — one of the largest dental chains in the U.S. — operates clinics in Dothan and Montgomery, and is the center of much of the Senate investigation and report.


According to the report, Small Smiles, managed by Nashville-based Church Street Health Management, skirts laws in states — including Alabama’s Dental Practice Act — that ban dental clinics from being owned by anyone other than a licensed dentist.


The company does that by entering into contracts with “owner” dentists licensed in the state in which the clinic operates, according to the report. CSHM claims to only manage the clinics, the report’s authors write.


But the company retains control of daily operation, according to the report, from hiring, firing and training staff to controlling the bank account and setting production goals that require dentists to treat large numbers of mostly low-income children eligible for Medicaid.

Read the rest of this in-depth report here.  Don’t forget to make your comments.

http://annistonstar.com/view/full_story/23212853/article-Alabama-dental-clinics-operating-illegally--Senate-report-says?instance=top_center_featured

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

WTAE Logo

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: http://www.wtae.com/news/local/investigations/senate-report-says-small-smiles-dental-clinics-wasting-taxpayer-money/-/12023024/21150480/-/n6efhkz/-/index.html#ixzz2a4MbwQOF

Tuesday, July 23, 2013

Senators’ Report Reveals Oxon Hill Maryland Small Smiles As Bad Today As It Was In The Beginning.

Despite signing a Corporate Integrity Agreement with the US Government in 2010 Small Smiles Dental Centers continue with their fraud and abuse of children as reported in The Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program issued by Committee on Finance United States Senate, Max Bacus,Chairman and Committee On The Judiciary United States Senate, Chuck Grassley, Ranking Member, July 2013.

(Despite the 1,500 pages in the report only pages 1-33 (5-37 of the pdf file) are the findings and recommendations, the rest are exhibits

Oxon Hill Maryland

Oxon Hill, Maryland was one of the dental centers reported on in 2007 which brought Small Smiles Dental Centers to the public’s attention.  It’s been 6 years and appears nothing has changed much.  Here is just some of what the Joint Senate report says about the Oxon Hill Small Smiles Clinic:

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.”
and
…"We've taken action to help CSHM improve its quality of care and management,"
and
…“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 .

Saturday, July 06, 2013

CSHM’s Small Smiles Dental Centers Up to Same Old Crap

No, this is not big surprise; it’s been around 18 years. This business has been hanging on since 1995 when Eddie DeRose, Michael DeRose, Adolph Padula and John Parrish open its second dental clinic in Colorado.  Then came the first phase expansion with the creation of DeRose Management in 1998, operation Children’s Medicaid Dental Centers in Colorado and New Mexico.  Becoming so highly lucrative in the business of abusing children and defrauding Medicaid under the guise of providing dental care to the “underserved”, FORBA was formed by the “family” and expansion across the country began.  In 2006 the “family” found a group of idiots, including a Bahraini banker, to buy it for $435 million dollars.  In 2012, this group filed bankruptcy after 10 years of reports of child abuse and fraud finally caught the attention of Health and Human Services and they were investigated and fined $10 million.  The first reports were around 2003.

Lately, I’ve received two emails from people who CSHM have tried to recruit. As you can see emails dentists have shared nothing has changed.


From: Scott Shue [mailto:sshue@cshm.com]
Sent: 
To: 
Subject: Lead Dentist Opening

Employment with guaranteed base salary and monthly bonus.  Benefits include medical, dental, vision, disability, etc.  Malpractice is covered.  We offer 2 days of CME and 401k with 5% match and a 4-year vesting schedule.  General dentistry with an emphasis on pediatrics.  Salary range of $150,000 to $180,000 for the Lead position.  Efficiency-based model utilizing DA’s with expanded functions, office manager and clinical coordinator.  The requirements for the Lead Dentist position is to establish conformity, a congenial work environment, development of other Associates, etc.

…Salary is determined by experience, clinical expertise and interview/leadership skill which would be part of a discovery effort throughout the interview process.  Monthly bonuses are a % of the location’s net profit.  Basically, the pool is 35% of the total profit would be split between the dentists.  The Lead would then get an additional 10% and the Owners get an additional 5% for each location.  We do not have production “quotas”, just daily/monthly expectations

Scott M. Shue | Recruiter | CSHM LLC |
618 Church Street, Suite 520
Nashville, TN 37219
C: 770.855.1877 | O: 615.750.0342 | F: 615.986.1705
email: sshue@cshm.com

cshm

 

 


FYI – Dr. Jodi Kuhn, DDS the scam owner dentist for Small Smiles Dental Centers has now worked her way up to being called “owner of at least 11 clinics.  Five in Colorado, Five in Ohio and 1 in Kentucky. 

There are two types of management companies and below is a comprehensive comparison of the two.

Corporate DMSO

Dental Consultants and Managers

View Dentistry As A Business

View Dentistry As A Medical Profession

Employ The Dentist and Staff

Are Employed by The Dentist Who Owns The Practice

Own The Dental Offices

Manage Dental Offices As Needed by The Dentist

Are Backed By Wall Street Investors

Recommend Funding Solutions

Award Themselves with Dentist’s Earnings By Sweeping The Practice’s Bank Account

Invoice Dentist Practice and Take Payment Only For Services Rendered

Focus On Production Per Patient Agenda

Focus on Assisting Dentist With Quality Non-Medical Service.

Exploit Dentists’ Lack of Business Training

Teach, Mentor, and Assist Dentists With Business Needs

Have Fiduciary Duty To Financiers And Shareholders

Have Fiduciary Duty to the Dentist Who Hired Them

Convince Dentists They Don’t Need To Get Involved With Back-Office Operations

Encourage Dentists To Be Involved In All Management Decisions Of The Practice

Retreat and Hang Dentists Out To Dry In Times Of Trouble

Support Dentists And Offer Guidance Through Any Problem

Deploy Corporate Employed Office Managers To Reinforce Who’s In Control

Respect They Are Employed By The Dentists.

Understand High Profit Business Models

Understand Business Solutions For Dentists

Have an Master of Business Administration Degree

Have a Doctor of Dentistry Degree

Violate State Laws i.e. Dental Practice Acts To Hide True Ownership

Do Not Violate Laws When They Own A Dental Practice

Best Financial Gain Strategy With The Patient-Doctor Relationship

Do Not Come Between The Patient and The Doctor When Determining Treatment Options

View Dentists As Assembly Line Workers

Understand Dentists Are Medical Professionals Delivering Medical Care

Follow An Assembly Line Cookie-Cutter Business Models In Each Clinic

Provide Á la Carte Custom Services Per Owner Dentist Request

Set Quotas, Reward Top Producers With Bonuses and Dispose Of Non-Producers

Recommend Office Policies for Long Term Sustainability

Choose Suppliers And Vendors Offering Sub-Standard Materials

Recommend Trusted Suppliers and Vendors

Goal To Increase Profits Simply For Future Sale of Company

Goal To Promote Mom and Pop Practices

Control Every Aspect Of The Profession From Appointment To Patient Treatment Options

Provide Non-Medical Business Support Never Interfering With The Doctor Patient Relationship

Here is an example of a legitimate contract with a management service company looks like.

North Caroline DSO Management Services Agreement

Tuesday, March 12, 2013

WFAA’s dental fraud investigations recognized and lauded by Forbes

Ending White House Tours Instead Of Ending Medicare And Medicaid Fraud -

Merrill Matthews, Contributor
March 7, 2013

forbes

“White House Tours will be canceled effective Saturday, March 9, 2013 until further notice,” according to a White House email.  Meanwhile, billions of dollars pour out of Medicare and Medicaid because of waste and fraud.  Indeed, eliminating Medicare and Medicaid fraud, rather than White House tours, would offset the sequester cuts for the next decade.

two idiotsI don’t know how much money President Obama thinks it saves by canceling White House tours, though I’ll bet it’s a lot less than one of his golfing trips on Air Force One, which costs about $180,000 an hour to fly.

But we do have several estimates of how much Medicare and Medicaid fraud cost.  Typical estimates, which have been echoed by the Obama administration, put the figure in the $60 billion a year range for each program.

A study by the Rand Corporation pegged Medicare and Medicaid fraud at about $98 billion in 2011, roughly equal to the future annual budget cuts (actually, reductions in the rate of growth) imposed by the sequester.

The Government Accountability Office’s (GAO) most recent estimate for Medicare, released in February, claimed there was a total of $44 billion in improper payments in 2012.  That figure is a little lower than the $48 billion for 2010.

Not all of the GAO calculation is fraud.  It includes overpayments and underpayments, unnecessary services, coding errors and other problems.  And there is fraud that isn’t detected by the GAO report.  But you get the idea; it’s a big problem and getting bigger as criminals and the mob get more brazen in their efforts.  For example:

Thursday, December 13, 2012

Health and Human Services or Health and Hedge-fund Services? When it comes to Medicaid dental mills, it’s the latter.

December 11, 2012
On Tuesday, December 11, 2012, The Today Show aired an investigative report about the on going troubles at the Small Smiles Dental Centers. Interviews included one with Health and Human Services (HHS) officials in charge of overseeing the compliance of the notoriously troubled clinics.

If you’ve not seen the report, please take time to do that here.

The segment included an interview with a HHS-OIG Branch spokesperson. However, if not for the HHS-OIG seal displayed one would presume it came out of the the PR department at CSHM headquarters.


NBS News Senior Investigative Correspondent, Lisa Myers asks HHS-OIG spokesperson, “They’ve had 4 bites at the apple, when is enough, enough?”  


HHS-OIG responded with this check list:HHS

1. “Dentists have been fired” – Well, dentists are fired there every day!! They are fired every day because they don’t meet the production numbers set by the corporate office. Their turn over had been setting at 48% since the beginning!

What about the Chief Dental Officer – Steven Adair, DDS?  He actually got a promotion. Dr. Adair is the author of the news letter for CSHM in which he suggests instead of the papoose board, try the “superman cape” method.

What is the Superman Cape Technique? Here, read this!

Compliance officers? – Yes, a few. They have burned through 3 in 2.5 years. CSHM will not hesitate to been throw one under the bus, blaming them for falsified reports to the OIG.

2. “Clinics have been closed” – Yes, they have filed bankruptcy! The started closing clinics in early 2011! HHS only forced 1 clinic in actually close – Manassas Virginia.

3. “This is not the same company” – True, it simply filed for bankruptcy, reorganized with some of the same investors in the background, and changed it’s name, replaced the CEO and President. But that was in 2011!

3. “The Independent Monitor is telling us that Quality of Care is consistently improving” – The same independent monitor in place for 3 years! The one CSHM pays. The one whose head dental investigator is buddies with the company’s Chief Dental Officer. So exactly when did that “improvement” begin? June of 2012? Certainly not in April 2012? The new people in charge actually  stepped in October 2011. It just wasn’t on paper with the bankruptcy court until June 2012.

The company has been in the news, how many times since 2007?
Countless!!!

Tuesday, December 11, 2012

2012 Small Smiles investigation by NBS shows abuse of children continues despite actions taken by HHS

By Talesha Reynolds and Lisa Myers
ssofdenver
It’s just over 5 years since HHS-OIG and DOJ began an investigation of Small Smiles Dental Centers.
It’s 3 years after the company was put under a Corporate Integrity Agreement.
Small Smiles abuse continues. In the new investigation -  HHS-OIG sound more like the company's PR firm than protectors of public health; Senator Grassley calls for the company to be closed down and says it’s all about the dollars.
today show
Click here for the full report.
Transcript of the video


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Visits to the dentist can be upsetting for little children, but when Autum Archuleta took her son Nathan to a Small Smiles dental clinic in February 2010, it was beyond anything she could have imagined. The dentist gave Nathan, then almost 3, three crowns, two baby root canals and six silver fillings in 25 minutes.
While in the waiting room, Archuleta says she heard her son screaming and burst into the treatment room. She says Nathan was crying and struggling to move while being held down by three clinic employees and wrapped from his head to his feet in a stabilization device called a papoose board. She thinks he wasn't properly numbed.
"He wasn't the same for a long time after we brought him home," Archuleta said. "He cried a lot...He wasn't my little boy. He didn't smile...The night terrors were the worst. I mean it was a lot of sleepless nights."
A dentist who later reviewed Nathan's records said the work was shoddy and many procedures unnecessary. A dentist who saw Nathan the following year wrote that he had "severe situational trauma."
"To me I think they did it for the money," Archuleta said of Small Smiles. "Flat-out did it for the money. Because it was Medicaid and Medicaid would pay them."
An NBC News investigation of the performance of Small Smiles' 63 dental clinics over the last three years found repeated allegations of substandard work and unnecessary procedures which drove up the cost to taxpayers. The allegations came from anguished parents, government investigators and former employees around the country.
Such practices violate a settlement the company reached with the Justice Department in January 2010, following allegations that it was bilking taxpayers by doing unnecessary and substandard procedures on low-income children.
At the time, Tony West, Assistant Attorney General for the Civil Division of the Department of Justice said, "We have zero tolerance for those who break the law to exploit children in need."
The company that managed Small Smiles and affiliated clinics agreed to significantly alter its practices and subject itself to independent monitoring. It also agreed to pay $24 million, without admitting wrongdoing.
But three years later, records show the company has not cleaned up its act.
"This company sees dollar signs in the eyes of every child they bring in," Senator Chuck Grassley told NBC News. Grassley has been investigating dental organizations whose primary source of revenue is Medicaid. He says Small Smiles practices assembly-line treatment, focused more on quantity than quality.
"This whole investigation kind of leads us to two things. To a conclusion that the tax payers are being fleeced, and children are being abused." Grassley said.
Small Smiles clinics are managed by a private corporation called CSHM, LLC, which was until June called Church Street Health Management.
The Department of Health and Human Services Office of the Inspector General (HHS OIG) is responsible for monitoring the clinics and rendering penalties when appropriate.
Lisa Re, a branch chief who heads an HHS OIG team of attorneys, says CSHM is improving since it emerged from bankruptcy in June 2012 with a new CEO and leadership.
"Recently, under new management, I would say that it is getting much better."
But according to letters from HHS OIG to Church Street, the compliance has been inconsistent and sometimes alarming.
In May, the office required CSHM to temporarily close a facility in Oxon Hill, Maryland to train staff on "the appropriate use of mouth props, patient stabilization practices, appropriate use and administration of anesthesia," among other things. Nine of 30 records the independent monitor reviewed "did not provide any documentation or radiographic evidence to support the medical necessity for the treatment provided. Six of those nine records showed baby root canals were performed "without medical necessity."
The OIG required the company to divest from a location in Manassas, VA in March because of "flagrant violations." A 2011 audit at that clinic found 104 of 244 baby root canals performed by the lead dentist to be medically unnecessary. In a sample of 34 records, 20 patients were restrained and given baby root canals with insufficient anesthesia. The monitor expressed concern that the children "were resisting treatment because they were being hurt."
In June the office fined CSHM 100,000 dollars after an audit found multiple breaches at an Ohio clinic, including treatments performed without medical necessity, incomplete or poorly done root canals, crowns places on "non-restorable" teeth and "poor techniques of administering local anesthesia." Six of seven dentists performed root canals on children that were not needed.
Last year, the agency issued a 230,000 dollar penalty, the largest it has ever levied, for multiple failures to comply with provisions of the government agreement. Among the breaches, the company failed to meet training and education requirements.
Still, Small Smiles continues to rake in millions in Medicaid dollars. Despite multiple threats to exclude the company from receiving federal funds, it made 150 million dollars in revenue from Medicaid in 2011.
The HHS OIG has given Church Street multiple chances to keep the clinics in business, levying penalties against the company and threatening to exclude them from receiving federal dollars. But the threats generally come with an out — a way to repair the breaches and avoid being exclusion.
Senator Grassley believes that cycle should come to an end.
"The inspector general has given this group a lot of second chances. Every time they get their hand in the cookie jar. All sorts of excuses. So you get back to how long can this go on — the fleecing of the tax payers, the abuse of children? And you get back to the point that maybe it's about time for the inspector general to disqualify this company from Medicaid."
DENTAL CARE VACUUMS CREATE LIMITED OPTIONS IN LOW-INCOME NEIGHBORHOODS
Small Smiles treats about 500,000 children a year. Jamier Brown, 4, was one of them. His mother Jasmine brought him to Small Smiles in Dayton, Ohio at the end of 2011 because she couldn't afford her other options.
"I knew that his mouth needed attention. And he was complaining that his teeth were hurting, so I just couldn't wait around to see when I could get the money. I had to go as soon as I could," she said.
Jamier received caps and fillings in most of his mouth in January.  Months later, he is still in pain.  The gum line is discolored where his front teeth we capped and Jamier says, "It hurts all the time."
Two dentists who reviewed Jamier's records said he should have been treated by a pediatric dentist, most likely in the hospital under general anesthesia. One called the treatment on his front teeth "inadequate."
At the time Jamier was treated, Jasmine was in Job Corps and living with her mother. She blames herself for what happened to her son.
"It's kinda my fault," she said as tears rolled down her face, "Because if I would have had the money, he probably wouldn't have felt any of that pain that he had to go through."
The guilt Brown feels is common among parents who spoke with NBC News and claimed their children were hurt at Small Smiles. They all said they didn’t know where else to go.
According to the Centers for Medicare and Medicaid Services, 31.5 million children were eligible for dental coverage through Medicaid in fiscal year 2011, but only 14.7 million children utilized a dental or oral health service.
Four out of five dentists don't take Medicaid, some because they just don't treat children but others complain of low reimbursement rates. Dr. Warren Brill is the president elect of the American Academy of Pediatric Dentistry (AAPD). He has his own practice in Baltimore, MD and 85 percent of his patients are on Medicaid.
"Reimbursement rates are a large factor in terms of dentists not accepting children on Medicaid, because the fees that they get are often times lower than the cost of providing the care," he said.
According to AAPD 70 percent of its members accept Medicaid. But only 3.5 percent of all professionally active dentists practice that specialty.
Nevertheless, Dr. Brill says parents of children on public insurance can find quality care.
"It's a question of learning how to make the appointment, getting referrals from state health departments, from dental associations, from friends and relatives. Parents that find those avenues should be able to find a dentist for their children."
DOES PROFIT MODEL PUT CHILDREN AT RISK?
Because Medicaid reimbursement rates are lower than what dentists charge other patients, critics say to make a profit, the clinics rely on volume.
Dr. Kianor Shah worked for Small Smiles briefly in 2011.  He says he left after witnessing disturbing practices. The dentist showed NBC News notes he took about treatments he observed during his time there. Scattered across several pages were words like "restraint brutal," "unnecessary" and "no way."
"I observed excessive use of the papoose board and excessive use of force to restrain children as well as overtreatment for procedures that could have been done with much less invasive approach."
Shah claims dentists were coerced into abusing children and overcharging Medicaid by the promise of bonuses and pressure from management.
"I was advised, quote unquote, 'The dentists eat what they kill.' That means that they're gonna get paid for as much work as they do on those Medicaid kids. And that was about the last straw for me."
Senator Grassley's investigation involves dental management companies that are controlled by corporate investors. Many states require dentists to own the clinics but the management companies, like CSHM, effectively control the operations.
"Our investigation has found a lot of private equity money being invested in companies that are doing everything they can in the most sophisticated way to take as much money out of Medicaid as they can. And in the process of just milking the Medicaid program, we're finding a lot of abuse of children."
PROGRESSIVE IMPROVEMENT AT SMALL SMILES
The Inspector General's office says the Small Smiles clinics have progressively improved, and while that improvement has been "uneven," the company is providing essential care to a vulnerable population. The agency maintains that it is better to aggressively monitor the company than to shutter it.
"If we had closed down Small Smiles last year, there would have been an uncontrolled shut down of this company leaving half a million kids scrambling for dental care," said Lisa Re.
The issue is further complicated by the states, which are responsible for administering Medicaid. The OIG surveyed states about the impact of closing the clinics and got a strong reaction.
"Some of the states were alarmed that we were even considering closing any of the clinics because they simply didn't have enough dentists to provide any care to these kids," said Re.
The attorney said in the last couple of years the office found five clinics to have the most significant problems.
"It's important to understand that not every clinic is providing bad care. If that were the case, this is an easy decision."
According to an affidavit in the Church Street bankruptcy filing earlier this year, "more than 1.5 million patients have been served during the past five years, improving overall dental health and access to care in many low-income areas in the 22 states in which the Company has had a presence."
Chris and Loretta Trujillo are grateful for the care the Small Smiles in Denver provides their children. They say it is very difficult to find dentists who take Medicaid and their children, Jordan, Jazmin and Faith, have never had a bad experience.
"My kids have never been scared coming here," said mom Loretta. "They're excited to come."
The Inspector General's office is taking on Small Smiles on a clinic-by-clinic basis, vigorously monitoring them and assessing penalties when appropriate.
"We have taken targeted and aggressive action against the clinics that provided bad care while allowing the company to provide good necessary care at the other clinics," she said, adding that the clinics are showing marked improvements since a new CEO, David Wilson, came on in June.
"The company as it operates today is simply not the same as the company that was repeatedly violating the agreement," Re insists.
In a statement to NBC News, CSHM's Wilson wrote, "Patients are at the center of everything we do at CSHM. CSHM LLC supports our affiliated dental centers so that they can continue to provide access to quality dental care. Our dental centers serve approximately one million patient visits per year, primarily to children in communities with under-served access to dental care."
Following an alarming audit of the Small Smiles clinic in Youngstown, Ohio that found substandard and unnecessary care, the new management company, which had just been formed, fired nine dentists there. The Inspector General's office called that action encouraging.
CSHM stressed its commitment to quality care. "Under the new management team, more than 50 new dentists have joined CSHM affiliated centers and the company continues to support their ongoing efforts to recruit qualified dentists."
That is simply not enough for Jasmine Brown. "I don't want anybody else's child to have to go through what my son went through, especially being that young. That's traumatic. That's something that could follow him the rest of his life."
Jasmine is now holding down two jobs — one as a pharmacy tech at CVS, the other as a security guard at a men and women's shelter. She says she can now afford to get Jamier the care he needs.

Monday, December 10, 2012

Report on Small Smiles Dental Centers to air

 

today show Tomorrow morning, Tuesday December 11, 2012 the Today Show will air a piece on Small Smiles Dental Centers – scheduled to air between 7:30 – 8:00 AM Eastern Time.
   

Wednesday, July 04, 2012

No one has stopped the “Child Abuse for Medicaid Fraud” scheme; not yet anyway.

1997 – Drs. Michael and Eddie DeRose along with Dan “put coke machines in schools” DeRose started opening dental centers to abuse children so they could defraud Medicaid, then build a football stadium in their own honor.

2001 – Dr. Tu M. Tran and Dr. Thien Chi Pham were dentists working at Smile High Dentistry in Colorado. Smiles High Dentistry is part of the Small Smiles Dental chain.

2002 – Tran and Pham were convinced to move to Atlanta and open up Kool Smiles, starting with 2 centers.

2004 – Friedman, Fleishcher and Lowe bought the centers and established NCDR, LLC to be the dental management division of FFL.

2006 – First Islamic Bank (aka Arcaptia aka Crescent Capital) gave the DeRoses $435-million for the dental centers.

2007 – In Georgia two companies who over saw Georgia's Medicaid benefits kicked Kool Smiles out of their network of dental providers for it’s Medicaid patients. Kool Smiles said it was because Wellcare wanted to cut it’s own costs! Wellcare said it was because children being abused for profit and fraud. Georgia agreed with Wellcare, and found over 6% of all Kool Smiles patients files didn’t need the care they received and over 3% of the treatment was substandard.

2012 - We are still where we were in 2007 with Kool Smiles – children abused, substandard treatment, fraud.

With Small Smiles nothing much has moved either. Pretty close to the same as in 2003 when reports of its child abuse first surfaced – 11 very long years have passed and we are zooming toward year number 12.

Kool Smiles continued to grow to over 120 dental centers today Small Smiles topped out at 72 or 73. Hundreds of dentists, who likely worked for one of these mills, broke off and opened their own smaller versions of this business mode- Abuse and Defraud for Profit. Adventure Dental and Vision is just one example. Their “owner” also worked for a Small Smiles Dental Center.

Small Smiles alone, treats 1-million children a year.

There have been numerous news reports on Kool Smiles Dental Centers since it’s beginning. There have been at least 72 73 news reports on Small Smiles Dental Centers since 2003.

Each report, from coast to coast, contained the exact same allegations:

  • Children being restrained and physically assaulted.
  • Unnecessary overtreatment.
  • Parents filing complaints and nothing being done.
  • A State or Federal Agency is Investigating.

There have been a few letters mailed out scolding the business practices, a tiny weeny fine or two – (that has not been paid yet) and a couple of Corporate Integrity Agreements that the executives wiped their asses on. (well, it’s true!) An a few “official” reports. Personally I’m not sure what a “report” actually accomplishes.

Here is reporter, Sydney Freedberg's report for Bloomberg, published just last week!

Today is July 4, 2012 and hundreds of these little houses of horrors will open their doors tomorrow.

So far Small Smiles has seen:

  • $24-million dollar fine they have not paid
  • A 66 page Corporate Integrity Agreement they have not followed
  • A few scolding letters with no bite
  • A $230,00 fine – they have not paid. (the actual fines for all the violations amounted to millions, but they got a discount)
  • One measly dental center in Manassas, Virginia they swear they do not own had to be transferred to a new owner
  • The Oxon Hill dental center closed for two days of training! I’m NOT kidding!!
  • Checks from the Medicaid fund still arriving in their bank accounts daily.

Hell, no wonder everyone wants in on the action.

CSHM Breach of Corporate Integrity Agreement March13 2012 <p>&nbsp;</p>

On March 7, 2012, just days after filing bankruptcy, their independent monitor did a check of the Oxon Hill Small Smiles and turned up all kinds of problems. On May 15, 2012 HHS once again sent out another letter, telling them to shut Oxon Hill down for a two day training session.

The letter stress HHS’s concern that just days prior to the March 7, 2012 monitor visits, that the Chief Compliance Officer – Lorri Steiner,- the Chief Dental Officer, Steven Adair or Gus Ghassen or both – the SVP of Operations, Kevin Reilly,- the Executive Director of Operations,Lisa Mullinix or Scott Nearing maybe- the Compliance Attorney, Sheila Sawyer, and the Regional Director, Dr. Marlene Navedo had been to Oxon Hill Small Smiles and couldn’t find a thing wrong. NOT ONE THING! How can that be???

Are they incompetent or criminals, it has to be one or the other. Are the same folks still running the show down there? Yes indeed…several of them are still there.

Something big happened that was quite serious, I don’t know what, by the Oral Surgeon at the Oxon Hill Small Smiles on February 20,2012. I don’t know if I want to know either.

CSHM Agreement with Office of Inspector General May 15 2012

Next Wednesday, July 11, 2012 is the dead line for CSHM to have reviewed and report past overtreatment at the Manassas clinic. As Bloomberg Businessweek reported, with 42% of all the root canals checked, (104 unnecessary root canals out of 244) deemed unnecessary I’m guessing that report will not look good for the dentists working there, or the company.

This company has been under the watchful eye of government regulators since 2007, when the investigation first began. Can you get your head around the fact they have not changed their ways in 5 years!!!! 

Arrests next week?

Tuesday, July 03, 2012

Small Smiles Dental Changing It’s Ways… HA! –that’s what they said the last time they changed their name, and the time before that and the time before that…

Small Smiles is saying it’s changed it’s ways, I beg to differ, since we’ve heard that before…several times. This company has been under the watchful eye of government regulators since 2007, when the investigation first began. Can you get your head around the fact they have not changed their ways in 5 years!!!!
It’s changed it’s name a few times, but not it’s ways!
Struggling dental chain looks to mend its ways
By Rob Goszkowski, Assistant Editor
July 4, 2012 -- Church Street Health Management, a private-equity-backed company managing 63 dental centers under various "Smiles" brands in 21 U.S. states, has emerged from bankruptcy with new owners, a new identity, and a new strategy for staying in the dental game.
Now going by the moniker CSHM, the company has a history of legal problems that forced it to file for bankruptcy earlier this year and prompted additional federal scrutiny.
For example, in January 2010, while still known as Forba Holdings, the company paid $24 million plus interest to settle allegations of Medicaid fraud with 22 states and the U.S. Department of Justice. The fine resulted in part from a policy of "converting" patients, whereby dentists were systematically urged to perform additional procedures and the number of procedures performed was tracked.
Read the rest over on Dr. Bicuspid

Senators Chuck Grassley and Senator Max Baucus inquire into illegal ownership of dental chains.

Did the Senators get nothing but lies from Small Smiles Dental, Kool Smiles Dental, Reachout Healthcare America, and Aspen? I'll let you decide.

Small Smiles Dental attorney's, King and Spalding, respond to Senator Grassley’s Investigators - November 29, 2011

Second response letter from Small Smiles Dental Centers to Senator Grassley’s Investigators - December 16, 2011

Kool Smiles Dental responds to Senators Grassley and Baucus Inquiry - February 3, 2012

Reachout Healthcare America responds to Senators Grassley and Baucus inquiry- February 23, 2012

Reachout Healthcare America's second response to Senators Grassley and Baucus - March 22, 2012

Aspen Dental response to Senators Grassley and Baucus inquiry -February 13, 2012

Aspen Dental's second response to Senators Grassley and Baucus - April 18, 2012

Thursday, May 10, 2012

The $700,000 cure for Church Street Health Management

This morning at 9:00 a hearing was to be held in Nashville Bankruptcy court whereby Church Street Health Management, LLC was asking the court to modify the final Debtors In Possession (DIP) Order and to reschedule the closing of the sale of Church Street Health Management ,LLC to CSHM, LLC. They want to set it for May 31, 2012 instead of May 30, 2012 and they want to remove a legal service agreement with King and Spalding. (lol…they are gonna miss that income!)
Church Street Health Management , LLC and CSHM, LLC are two completely different companies now, so keep that in mind from this point forward. Church Street Health Management, EEHC, LLC, FORBA NY, LLC and Small Smiles Holdings, LLC are now combined into one company, namely CSHM, LLC. At least that is what it will become when the sale closes with Garrision
In their “Assumption Notice” (Doc 301, 302, and 302 Schedule A) is listed all the contract and obligations the new buyer will assume and have possession of at closing of this Rule 363 sale. The first one filed May 1, 2012 had 14 pages of those phony Management Service Agreements with phony clinic owners and employment agreement contracts, intellectual property such as trademarks, non-compete contracts with the original founders-The DeRose-Padula family- and other miscellaneous agreement, contracts and business agreement. A new and amended Schedule A was filed the next day, May 2, 2012. Yes, there was a change, a tiny one; King and Spalding were removed as having a Legal Service Agreement with the new CSHM, LLC.
From reading the “Assumption Notice” , the new new CSHM, LLC will only “assume” a little over $700k ($707,399) (see assumptions and "cure" amounts here)of Church Street Health Management, LLC, EEHC, LLC, FORBA, NY, LLC and Small Smiles Holdings, LLC $23,607,147.40 of debt. (According to Form 1 Schedule F here-Doc 213, starting on page 51)
Suspiciously missing from the debt the new buyer would now assume is $4,911,378 listed as still being owed to several states on a March 23, 2012 report. (Here on page 51)
BTW, who were those $10,000 loans made to that were listed on the March 2012 expense report?! Who loans money when they are broke? (see here on page 6)