Small Smiles DC #2 Opening Soon?

New Small Smiles opening soon in DC?

Small Smiles Still Abusing Children - Corporate Integrity Agreement A Failure

FORBA's Small Smiles Dental Clinics in Oklahoma is looking for 'associate' dentists for its Oklahoma Smiles clinic located in North Oklahoma City while under the cloud of a class action suit recently filed alleging more child abuse and assault on children in these clinics.

As usual the ad talks about working in, and I quote:

"our rewarding work environment!".

About the only thing "rewarding" thing you will likely get in working at any of these clinics seems to be the extremely high risk of a malpractice lawsuit that can and will haunt you for years to come!  Make sure you get "tail" insurance!  In fact, I would demand it!  Legal fees alone could bring you to bankruptcy. I think I would also want "Claims Based" insurance and not "Occurrence Based".  Again, because of claims that could arise way into the future. 

In some states children have many years to file suit for injuries that occurred when they were small.  What if you treated a four year old who lives in a state where he/she can file an injury claim until they are 20, that is 16 years you have to worry about keeping your "tail" covered.  Is a job at FORBA and its Small Smiles clinics worth it.  This is true for Kool Smiles and other dentists "over" serving children for a dollar.

I would not be surprised, after all the claims being filed by former Small Smiles patients, to find malpractice insurance premiums skyrocket for dentist and/or other staff who had previously worked for FORBA's Small Smiles clinics or other dental mills.

"We offer excellent earning potential based on collections with a guaranteed minimum income"

" We also offer a benefits package that is hard to beat (including 401(k) retirement with company match and 100% coverage for health insurance, malpractice insurance, disability insurance, continuing education, dues and fees). Relocation reimbursement offered and licensing assistance provided."

Please contact Jacob at:

Direct Phone: 719-562-4460

Email: jdkochenberger@forba.com

Fax: 719-584-7697

If I were to work for these scumbags, which I would NEVER do if I planned on any type of good reputation carrying through in my career I would pay close attention to the bold terms highlighted above.

I would also worry about the stringent contract presented to me and have my own attorney look it over before signing, as you should for any contract!  Contract always favor the presenter of the contract, i.e. FORBA.

I would also worry about the Corporate Integrity Agreement this company has signed with the Federal Government.  I was told that FORBA requested its employees to also sign this thing.   Do you honestly think, FORBA will protect you?  

Presently they are having problems with Insurance coverage, themselves.  Not sure how they  feel they can offer up something in which they may not have access. 

Here is a comment I recently received on the matter when FORBA approached them to renew their contract under the new "collections" based salary :

As a dentist who just ended their contract with Forba recently, I would agree with you on many points here.  The worst part about the 'percentage' contract is how low it is.

For example, any private practice employer would pay between 25-30% of collections.  I received a printout of the breakdown for the percentage from Forba even though I only had a few weeks left on my contract and I was only a part time hourly doctor. 

Needless to say, the amount of treatment that needs to be conducted in order for a doctor to meet their minimum salary based on the old contract, is about $3000 a day collections (including personal, ancillary, and clinic contributions to overall collections). 

Under my contract with another private practice, I would only need to collect $2000 a day.  What this means is that a doctor would have to collect 1.5x as much as I would to make the same amount of money, and that doesn't include the salary lost with PTO, vacation, and paid holidays. 

This also means that doctors may be more inclined to 'find' cavities than they were when they were on a set salary and could concentrate more on proper treatment and behavior management;  now it means that a doctor might be quicker to use a papoose or more aggressive with treatment planning than with the prior contract, just to make the same amount of money.

 As recently as August 9, 2010 there are reports of tying up children to overtreat!

Hello, my name is William and it is my belief that the Small Smiles dentistry clinic in Dothan Alabama abused my four year old daughter.

She went in for a "small" filling and was tied to a board, blindfolded with a rag and given two root canals and crowns in under twenty minutes.

This was three weeks ago on the 9th of August.

It wasn't until after a couple of days of ranting and raving before I discovered that I wasn't alone. I came across the 20/20 news report and SNAPPED I could not believe that not even a year after a federal suit they are still treating babies the same way.

I never would have taken my babies there had I known that they are the McDonald of dentistry. We trusted the recommendation of our local school system.
I have since learned of several other families who have treated the same way.

Thank you for your concern
William
smallsmilesabuse.com

On a side note here, the creeps running FORBA sure want to take our tax dollars and live like 'kings' but they sure get bent out of shape when you start naming names, don't they?  

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 

Kool Smiles Dentist in Kentucky

Dentists Who Are Medicaid Providers At Kool Smiles In Kentucky

Dr. Kumar Shalesh - left KS a year ago, according to commenter.

Dr. Jennifer Board

Dr. Jing Jing Zhang

Dr. Sara Trombetti (she's been with Kool Smiles and Small Smiles)

Dr. Alia Main

Jennifer Thomasson - according to commenter she is office manager

Dr. Polly Buckey (regional manager and one who refuse to show reporter the papoose boards)

Dr. Anne E. Smothers

Dr. Tu Tran ( stinking founder)

Dr. Solitaire S. Wix

Where is David Strange, he's usually registered in every state like he actually practiced dentistry.  What about Pham, oh yeah, he's not there any longer.

Dr. Roy Shelburne's Warning To Dentist After His Release From Prison

Dr. Roy Shelburne was convicted on Medicaid Fraud charges in 2008.  Here, Dr. Shelburne, released from prison in May 2010, warns dentists.(Interview by Kevin Henry)

• 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. 

*********************

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.

  Raven's Memorial Website

*********************

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

I'm wondering a couple things here:

1. Does Bianca work for Kool Smiles

2. Why do they still use prescription "pads".  Even Small Smiles uses electronic prescriptions!  Even though they were stupid enough to put them online.

3. Wonder why it took so long for the CVS on South Cherry to get a clue that Kool Smiles dental clinics probably shouldn't/wouldn't be writing scripts for "large" amounts of Oxycodone?

Hometown Annapolis:

A woman was arrested last night after trying to pass what city police said was a fraudulent prescription for oxycodone at an Annapolis-area drugstore.

Bianca Vivian Robinson, 21, of Poplar Grove St. in Baltimore, was arrested after she tried to get 90 tablets of the painkiller from the CVS pharmacy in Hillsmere at 7:53 p.m. using a prescription from Kool Smiles of Baltimore-Westside, ostensibly for a cousin residing in Baltimore.

The dental office told police a prescription pad had recently been stolen.

The same prescription had been presented at the CVS store on South Cherry Grove Avenue 30 minutes earlier, police said. A pharmacist there said she had been getting scripts for large amounts of oxycodone from Kool Smiles recently.

Police said Robinson was arrested on prescription fraud and other charges.

Potential New Hire Asking Question On Dental Forum About Compensation Based On Production at Small Smiles Clinics

July 7 and July 8, 2010 conversation between members of a forum for new dentists.  Wonder if it was "internal and confidential" then too?  Oh, wait, that was long before I wrote anything about the bait and switch contract for Small Smiles dentists.

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.

_____________________________________

Kool Smiles, Dentist and Assistant Sued For Leaving Burn On Child's Face-Lexington, KY

Kool Smiles, a dentist and dental assistant are being sued for injuring a child in Lexington, Kentucky.  According to the complaint the child's mother was refused access to her child and was forced to stay in the waiting room.  Anyone who knows anything about these dental mill knows is this fact.

 

[June 4, 2010 review of this clinic]

When the child came out he was crying and told him mommy they hurt him.  There is no telling what all these monsters did, but one thing for sure, the left a serious burn on his cheek.  His mother took him to the University of Kentucky  medical center to have the burn examined and was told it most likely would leave a permanent scar on the little boy's face.

Currently Harris Williams & Company are bidding for the purchase of Kool Smiles.  Honestly, I look forward to this, the deeper the pockets the more the rewards for all the thousands of children lining up for compensation from the abuse of Kool Smiles creepy, slimy, dentists and their assistants.  Expect Kool Smiles  liability insurance company to drop them like hot potatoes just as two have done with Small Smiles.  Then what?

(Harris Williams & Co. appear to be negotiators for Private Equity Firms, according to their website.  Wonder which firm really wants Kool Smiles?)

I hope the dental assistants working in these places do not make the mistake they are innocent bystanders.  This is one of those cases of "if you are not part of the solution, you are part of the problem".  Personally, I would roll on these creeps.

You either have the chance to stand up and report it, or sit in the defendants chair, it is your choice, choose wisely.  Do not end up like some I know who have tried to ride it out, thinking they "company" will have their lawyers protect you.  This is not likely to happen and you will likely be told to get your own attorney, only after you meet with their attorney's and they get all the evidence they can from you to help cover their ass and lay the blame in your lap.  I've seen it happen over and over again.

 

Kool Smiles defense to this action - "it was the child's fault."

Corporate Dental A Good Investment? Not for the patients!

I hope you don't want your dentist to have your best interest in mind, those who work for these places only need answer to shareholders and keep the bottom line in the black.  Know what that means, swift, cheap and low quality care and being sold crap you don't need. 

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.

[COULD!?  It has! They also failed to mention in most states they operate Illegally!]

Private equity firms already own the Forba and Bright Now! dental chains. Kool Smiles did not return calls for comment.

[Kool Smiles didn't return phone calls, well hell no, they didn't!]

Read more: http://www.nypost.com/p/news/business/private_equity_firms_ink_teeth_into_5HBGAj0ju7eQM0bIPPhCaJ#ixzz0xoHrpM8E