Wednesday, September 01, 2010
Universal Health Services- $210 million for Keys Group/Keystone Education and Youth Services
Universal Health Services 2005 Annual Report
page 89
paragraph 10.27:
Ownership Interest Purchase Agreement, dated as of October 3, 2005, among Harbinger Private Equity Fund I,L.L.C., Keystone Group Kids, Inc., Michael Lindley, Marty Weber, Ameris Healthcare Investments, LLC, Rainer Twiford, Al Smith, Mike White, Rodney Cawood, Buddy Turner, Jeff Cross, Gail Debiec, Brad Gardner, Brad Williams, Don Wert,Rob Minor, Mike McCulla, Jim Shaheen, Rob Gaeta, and Universal Health Services, Inc., previously filed as Exhibit 10.1 to Registrant’s Current Report on Form 8-K, dated October 11, 2005, is incorporated herein by reference.
UHS and Keystone purchase agreement
With this one acquisition,UHS Behavioral Health nearly doubled in size, adding a total of 46 Keystone facilities in ten states – including 21residential treatment
facilities with 1,280 beds,21 non-public therapeutic day schools, and four detention facilities.
The acquisition is expected to generate approximately $165 million of annual revenue. Just as important, it offers UHS exciting opportunities for entirely new behavioral care disciplines.
Keystone’s residential facilities and day schools have earned a national reputation for treating “at risk” young people with autism and other behavioral needs. .
These young people face serious problems, including disruptive or aggressive behavior, failing grades, addictions, and severe depression.
Generally, their families and schools have tried to help, but lack the resources and expertise needed to achieve breakthrough results.
Accepting even the kids that no one else will take, Keystone offers structure, teaching, discipline, and love – in a safe and supportive environment. Keystone provides each child with a service advocate, who represents the child’s best interests during every phase of the treatment process. The advocate works to find a program that will help the child. And, he or she serves as a liaison between the facility, the child’s family, and the referral source to ensure the highest
standards of quality care.
Commenting on the Keystone acquisition, Debra K. Osteen, President of UHS’s Behavioral Health division, stated, “The facilities we are acquiring provide an opportunity to expand our residential treatment facilities,
which have been a solid performer for the division.
“In addition,” Ms. Osteen said, “the acquisition enables us to enter a new business in non-public therapeutic day schools. We believe there is a need
for this service and hope to expand the current operations and grow in other areas of the country.”
While Keystone was the biggest development of 2005, it was not the only
acquisition made by our dynamic Behavioral Health division.
Structure:
Keys Group Holding,LLC
Children’s Comprehensive Services, Inc
Keystone/CCS Partners, LLC – 85% owned by Keys Group Holding,LLC and 15% owned by Children’s Comprehensive Services, Inc.
Kids First Foundation – non-profit
Keystone Nevada, LLC
Keystone Memphis, LLC
Keystone Education Transportation, LLC
Elmira NPS, LLC
Alicante School Elk Grove, LLC
Keystone Savannah, LLC
Keystone Newport News, LLC
Keystone Marion, LLC
Keystone WSNC, L.L.C.
Keystone Oklahoma City, LLC
CCS/Altacare of Arkansas, Inc.
Chad Youth Enhancement Center, Inc.
CCS/Bay County, Inc.
CCS/Meadow Pines, Inc.
Ventures Healthcare of Gainesville, Inc.
CCS/Little Rock, Inc.
CCS/Rivendell of Kentucky, Inc.
CCS/Lansing, Inc.
Associated Child Care Educational Services, Inc.
American Clinical Schools, Inc.
Alabama Clinical Schools, Inc.
Pennsylvania Clinical Schools, Inc.
Tennessee Clinical Schools, Inc.
Keystone NPS, LLC
Keystone Continuum, LLC
Keystone Detention, LLC
Keystone Richland Center, LLC
Keystone DJJ, LLC
Keystone Charlotte, LLC
Keystone JJAEP, LLC
Facilities
Alabama Clinical Schools AL
Tennessee Valley Juvenile Detention Center AL
Tuscaloosa Juvenile Detention Center AL
Bristol Youth Academy FL
Jacksonville Youth Center FL
The H.O.P.E. Program FL
Nueces County Juvenile Justice TX
Cedar Grove TN
Chad Youth Enhancement Center TN
Cherokee Park Youth Center TN
Compass Intervention Center TN
Hermitage Hall TN
McDowell Center for Children TN
Natchez Trace Youth Academy TN
Upper East Tennessee TN
Old Vineyard Youth Services NC
The Keys of the Carolinas NC
Keystone Newport News Youth Center VA
Marion Youth Center VA
Pennsylvania Clinical Schools PA
Children’s Comprehensive Services of Ohio OH
Turning Point Youth Center MI
Highlander Children’s Services CA
Keystone Carmichael CA
Keystone Desert Hot Springs CA
Keystone Elmira CA
Keystone Grand Terrace CA
Keystone Hemet CA
Keystone Highlander CA
Keystone Laguna CA
Keystone Mar Vista CA
Keystone Ramona CA
Keystone Rancho Cucamonga CA
Keystone Riverside CA
Keystone Steele Canyon CA
Keystone Vallejo CA
Keystone Van Nuys CA
Keystone Victorville CA
Keystone Ventura CA
CIT Capital Securities,LLC received $300,000 at closing
Waller Lansden received it’s fees
Tuesday, August 31, 2010
Kool Smiles Dentist in Kentucky
Dr. Roy Shelburne's Warning To Dentist After His Release From Prison
- If you work for a dental mill, do you know exactly what was billed by the Office Manager or Corporate after that file left your hands?
- Did they change your files, did they change your treatment plan?
- Are the details of what you did and WHY you did it well documented?
- Do you review your files to see that no one has altered your patients files, you should!
- Do you use a portable voice recorder after seeing patients to keep a record of your treatment?
- Do you think the corporate heads really have your best interest in mind? They do NOT!
Raven Marie Blanco Foundation
Raven Marie Blanco was killed by an overdose of drugs at the dental office of Dr. Michael Hechtkopf on March 7, 2007. She left behind a grieving family who have taken their grief and are using it to awaken the dental community, who have been sleeping at the wheel.
Children are dying, one a month since April 2010. The RMBF is asking the ADA and other Dental Organization to take a stronger look at the reasons children are dying in droves. The RMBF has created common sense solutions that will saves lives in the future.
So far the American Dental Association has failed in protecting citizens, especially children, from deaths at the hands of dentists here in the United States.
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From The Raven Marie Blanco Foundation:
The recent rise in pediatric deaths due to dental visit complications is absolutely getting out of control!
RMBF needs your support now more than ever.
We are partnering with Dr. Larry Sangrik, DDS to bring a Continuing Education Memorial Lecture on the "Six Links of Survival" to the dental community in an effort to better prepare them to handle Medical Emergencies.
To honor Raven’s life and perpetuate her memory, we established RMBF. The mission of RMBF is two-fold. Financially, we seek to raise funds for causes which directly impact children.
Our 5-year plan calls for us to place 5000 automatic electronic defibrillators (AEDs) in areas of need across the country, give a grant to assist the dental health needs of underserved children and provide financial assistance for a building project to a South African orphanage.
The second mission of RMBF is to raise awareness within the dental profession about the need for medical emergency preparedness in dental offices. That objective has proved to be even more challenging than raising funds.
When RMBF began, our initial goal was to get dentists to purchase an AED for their office. As we have become more knowledgeable about medical emergency preparedness, we have learned that many of the leading authorities base dental office preparations around a concept called the Six Links of Survival. The Six Links of Survival was developed the Institute of Medical Emergency Preparedness [IMEP] as a medical emergency preparedness program and teaching tool for dentists.
RMBF partnered with Dr. Larry Sangrik to bring a Continuing Education Memorial Lecture on the Six Links of Survival to the dental community in hopes of reducing the amount of unprepared reactions to medical emergencies.
Dr. Sangrik is a nationally renowned speaker, who has lectured to over 7500 dental professionals on this topic.
Our intention is to raise awareness in the minds of dentists about the need to prepare their offices for medical emergencies.
Six Links of Survival
-Regular dentist training
-Staff training
-Written office emergency manual
-Periodic mock emergency drills
-Proper emergency equipment
-Proper emergency medications
Since 1996 there have been 18 pediatric deaths related to dental complications. Mind you these are only the ones we know about.
That is 18 deaths in 14 years. At first glance the number is sad, but do you want to know something shocking? FOUR of the deaths occurred in the last FOUR months!
Yes, 22% of the deaths occurred in the last four months - add in Maddoux Cordova the 22-month old boy who died in December and you can clearly see that 1/3 of the deaths have happened within the last eight months!
The American Dental Association must update its medical emergency guidelines for dentists and they cannot deny our request that they hold a symposium to study the issue and the 6 Links concept in particular.
Pediatric deaths resulting from complications related to dental procedures are not a rarity people – they are an EPIDEMIC! RMBF will not take no for an answer.
RMBF sent out letters to the American Dental Association (ADA)
requesting that they pursue an update of its 2002 guidelines based on current knowledge, make the information easily accessible to dentists and to commit to regular monitoring of the recommendations to keep them timely.
Raven Marie Blanco Foundation on Facebook - Keep up with the progress
Raven Marie Blanco Foundation Website - You can help protect pediatric dental patients.
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More children have died since the government has included dental care under Medicaid/SCHIP programs. Of course this will be explained away as due to the increase in dental care.
If we are going to have those programs, of course dental as well as vision care should be included in Medicaid/SCHIP programs.
The argument to include dental care was that one child had died due to infection.
Take a minute and meet the children who are now dead. Many could have been prevented had common sense precautions been taken.
The ADA has not updated their guidelines since 2002! With the increase in pediatric treatments and skyrocketing deaths this is just unacceptable.
It is hard to believe this foundation needs to exist, but the dental community is resisting adding lifesaving equipment, as an Automatic Electronic Defibrillators (AED) to their repertoire.
Illinois and Florida have had to pass laws requiring AED's in dental offices, which cost between $1200 - $1800. However, many dentists are not maintaining or inspecting them on a regular basis, nor is the training in their use sufficient. Read more here.
As a side note here: Papoose boards range from $300 - $500 each.
Here is a comment from a dental forum regarding AED's:
I don't agree with making AEDs mandatory in ALL dental offices. When was the last time you went to a general practitioner MD's office and he had an AED on hand? It's ludicrous. Now, if you're doing sedation procedures, as this dentist was, then, you are a FOOL to not have such equipment, along with a pulse oximeter. I can't believe he didn't have one. He obviously didn't know how to titrate his dosage properly either, seeing that her blood levels were 3 times the level considered safe for a child her weight. Does the board in his state not regulate who can and who cannot practice sedation??? Here, in Louisiana, we can't even write for Valium for oral sedation as of a couple of years ago without first being re-certified in oral conscious sedation, regardless of how long you have been in practice and doing so.
In Illinois, the law will not apply to dentists who use only local anesthetics such as lidocaine or articaine. The original legislation included ALL office, but thanks to the Illinois State Dental Society, it was amended. Thank you so much ISDS. (sarcasm) Read more here.
Dental office can purchase one through the drive-thru sedation training called DOCS.
Woman Arrested For Kool Smiles Prescription Forgery
Sunday, August 29, 2010
Potential New Hire Asking Question On Dental Forum About Compensation Based On Production at Small Smiles Clinics
New Graduate asks:
Hi,
I will be interviewing for a position with Small Smiles. Here are the major pointers of the compensation and contract:
- Mon to Fri, 8 to 5
- 3 other dentists and 4 hygienists already working there.
- Production based compensation (22% of everything; xrays, hygiene exams, operative, exams, etc)
- Daily minimum $360 (but obviously this hardly happens, as I am told)
- $10k sign-on bonus.
- Average patient is billed $200 per visit, so I am told that I can see two patients at the same time, as well as hygiene exams too.
- 4 weeks paid holiday
- Did I mention this is a chain office?
Any pointers about this opportunity? Is this a good or bad deal for a new grad?
Fred:
Run for the hills
Wilma:
If it's truly a 'daily minimum,' get it in writing. But. c'mon - a franchise just for low-income with an average per visit charge of $200, and making the offer they are making you? If that doesn't sound fishy enough.....read this ( http://abcnews.go.com/2020/dental-chain-reaches-settlement-medical-fraud-performing-unnecessary/story?id=9615119 ) and then do as previously posted - run for the hills.
Ed:
I don't recommend franchise dental clinics for patients or people who are looking for work. I looked at the link above and I thought it was "sensational". Who really knows what shape the kids were in before getting in the chair. Most of the mothers look like trailer trash and probably couldn't tell the difference between a cavity and a raisin their kid just ate that happened to get jammed into a hole in their kids "toof". Sad that this is the only care available. I suspect their are at least a few who work in these places that truly do care and are trying to do the best with a very bad situation and make a difference in the lives of these unfortunate kids.
Catch a glimpse of the upper right quadrant of the kid early in this video that was not treated. Mom says his teeth were perfect before he got in the chair. Ignorant people see this stuff and think the dentists are evil. Ed
http://www.youtube.com/watch?v=wdxeG6F41uc&feature=related
Gene:
Small Smile mainly takes Medicaid and Chips insurance patients. They only way to squeeze 200$ out of these low reimbursment insurances is by aggressively over-treatment planning every case ( Which of course they are notorious for)
The worst part of working at Koolsmiles or SmallSmiles is that you will an office manager who will ensure that you meet these ridiculous production goals. If you do not produce you will called into the office and someone without a dental license will be telling you how to practice. "Dr. New Grad, Why don't start using the Papoose board. We have some Dentists producing 10,000$/ day." They don't give a crap that these kids are screaming in the back rooms and urinating on themselves out of sheer fear from the traumatic experiences they are subjected to.
The other worst part of working at the Smile Center/ Koolsmiles is that they set up the clinic so that the doctors will be fighting for production. You get a bonus if you produce X amount of dollars in operative. This will #1) lead to aggressive treatment planning #2) the doctors camp out in the operative rooms and fight over op patients.
Don't work for these guys or any smile-o-rama.
Barney:
Medicaid offices REQUIRE speed and efficiently to handle the volume of patients needed to offset the low compensation and profit margins. Right out of school, some docs may not have the clinical skill needed.
_____________________________________
Saturday, August 28, 2010
Kool Smiles, Dentist and Assistant Sued For Leaving Burn On Child's Face-Lexington, KY
Friday, August 27, 2010
Corporate Dental A Good Investment? Not for the patients!
The New York Post
The private-equity barbarians may soon be running a dental office near you.
In recent weeks private-equity firms have been bidding for two of the largest national chains of dentists' offices as they drill further into the space.
In fact, a PE firm is close to winning the auction for Syracuse-based Aspen Dental with a winning bid likely to stretch past $500 million. A separate auction for the slightly larger Kool Smiles chain is well underway, sources said.
Aspen, with its nearly 300 branches, is working with investment bank Moelis & Co. to sell itself. Kool Smiles, which generates $80 million in EBITDA (earnings before interest, taxes, depreciation and amortization), has hired investment bank Harris Williams, The Post has learned.
Financially, dental is the old-fashioned piece of the healthcare industry. Most practitioners still work outside a management practice and more than 80 percent work with, at most, one other dentist. Most importantly to private-equity firms, it is one of healthcare's last bastions of fee-based services, according to the American Dental Association.
Financial consultant Tom Climo said 89 percent of dental services, including preventative care, are covered by insurance, with patients only paying for oral and cosmetic surgery. Healthcare reform that is cutting into reimbursement for medical doctors is not affecting dentists, he said.
An investment banker said private-equity firms like dental offices because they sell for low valuations and one can borrow a fair amount of money against them because of reliable cash flow.
The downside, Climo said, is private-equity firms are likely to work dentists longer once they take over practices to boost profits and that could lead to worse service.
Private equity firms already own the Forba and Bright Now! dental chains. Kool Smiles did not return calls for comment.
Tuesday, August 24, 2010
Things FORBA Small Smiles Don't Want You To Know
Saturday, August 21, 2010
4 Year Old Tulsa Child Dead After Sedation At Pediatric Dental Group, Tulsa, Oklahoma – Charles Keithline, DDS! 4 Dead Children In 4 Months!
Dr. Charles Russell Keithline III's dental licenses ( # 3942) shows he has been disciplined before! Why is that not in the report? Call the Board of Dentistry (405) 524-9037 for more information.
Here is what I found:
Charges: practiced dentistry in an incompetent and/or negligent manner.
Action: 6 month suspension and 5 yrs. probation.
This death happened on August 14, 2010. The earliest reports I can find are from yesterday, August 20, 2010, and only from one source. Why?
***********
Tulsa, OK
By KIM ARCHER World Staff Writer
Published: 8/20/2010 11:00 PM
Last Modified: 8/20/2010 11:00 PM
The Tulsa Police Department and the Oklahoma Dentistry Board are investigating the death of a 4-year-old girl who had been put under sedation for a dental procedure at a Tulsa pediatric dental clinic.
Akasmse Rose Tecumseh of Morris died Aug. 14 after leaving Pediatric Dental Group, 602 S. Utica Ave.
“I can tell you we are working constantly on this,” said Linda Campbell, executive director of the Oklahoma Board of Dentistry. “We are working on the timeline.”
She said investigators have been at the clinic going through records this week to find out how long the sedative was administered and whether proper protocol was followed.
Campbell said the Tulsa Police Department is working with the board’s investigators on the case.
“Certainly one death is too many, but we are looking at this to ensure there is clear and convincing evidence” regarding any potential wrongdoing, she said.
The primary dentist at the clinic is listed on the group’s website as Dr. Charles Keithline, a fellow of the American Academy of Pediatric Dentistry and a diplomate of the board.
Keithline’s attorney, Keith Sweet of Oklahoma City, said the dentist could not comment about the patient, citing patient privacy laws. Campbell said an associate of Keithline’s performed the procedure.
Only seven people in Oklahoma are known to have died after being sedated at a dentist’s office, she said. Many were ruled natural deaths after investigations because the patients were found to have had pre-existing medical conditions, such as heart disease or asthma.
Before Akasmse’s death, the last death linked to sedation at a dental office was that of a 6-year-old boy in Muskogee six years ago, Campbell said.
In that case, the investigation found that a pharmacy erred by providing the patient a lethal dose of methadone instead of the prescribed sedative, she said. The dentist was exonerated.
According to the American Dental Association, the use of sedation and general anesthesia has been an integral part of dental practice since the 1840s.
If properly administered by trained personnel, sedation and general anesthesia are safe and effective, allowing millions of people access to comprehensive dental care who otherwise would not get it, the ADA says.
The ADA sets guidelines for the industry regarding the use of sedation and offers continuing education on proper monitoring and airway management during the use of general anesthesia.
Officials with the Oklahoma Dental Association would not comment.
Read more from this Tulsa World article at http://www.tulsaworld.com/news/article.aspx?subjectid=17&articleid=20100820_11_0_TheTul956938
The child was having some restorations done and crowns put on her deciduous teeth, according to Linda Campbell, executive director of the Oklahoma Board of Dentistry.
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Update Sept. 2, 2010
One story coming from the community is that Dr. Charles Keithline is charging the child's stepmother with causing the death of this child. He is saying she left his office and drove the child around in a hot car for three house. Of course Dr. Charles Keithline isn't planning on taking any responsibility.
Just because a child has an underlying medical condition does NOT mean the child died of "Natural Causes" and the dentist is off the hook.
It's clear this is what has happened as the article mentions the number of deaths in Oklahoma and all were ruled "natural deaths" because of other health issues. How in the hell does this let the dentist off the hook?
And screw the AAPD or ADA guidelines and comments. Remember they are the ones who sent out the "talking points" memo after deaths earlier this year to cover their (and their colleagues) asses!
I'm having big issues with this DOCS (Dental Organization For Conscious Sedation) Company, based in Seattle who delivering these "drive-thru" classes for dentists. They advertise and have testimonials from dentists who talk about how offering Conscious Sedation is another tool to increase their profits!
Related Articles:
Five Year Old David Liddell Death July 12, 2010
Deaths In Dental Chair On The Rise