Sunday, September 26, 2010

It is a Pulpotomy NOT Baby Root Canal

FYI

This term gets thrown around a lot in connection with Small Smiles and the other dental mills, but it's not correct.  It is not what they are doing to the children.

It is really a Pulpotomy!  In short the deciduous (primary/baby) tooth is drilled out, the pulp removed, leaving a chamber.  The tissue within the canals of the baby tooth that was connected to the pulp in allowed to remain.

tooth-anatomy

The chamber is then filled with "resorbable" material.  As the succedaneous (Permanent) tooth behind erupts and pushes out the primary tooth.  The pressure caused by the eruption causes cells to eat up the primary tooth roots, it loosens and falls out.  The roots of the baby teeth pretty much dissolve, and are absorbed into the body.   Remember the tooth you left for the tooth fairy, they didn't have roots.

Without getting into the pro's and con's of various materials poured into the chamber most include zinc oxide and eugenol (clove oil), iodoform paste, and calcium hydroxide.

So when you go looking for root canal on your medical records, you won't find it.  Look for pulpotomy, pulpotomy therapy, or code D3220, D3230 and D3240.

Speaking of the coding, the ADA standard billing codes are used.

In Texas code D3220 will earn a dentist $87.96

In North Carolina D3220 will earn a dentist $81.09

In Kentucky it will get the dentist $67.60

In Alabama only $49.00

Looking at the reimbursement fees, I would think being paid by FORBA on a production/billing basis is going to vary widely.   Dentists will be fighting over what state they get, won't they.

Friday, September 17, 2010

New Kool Smiles TV Ad – Don't Fall For It

Just caught the new Kool Smiles ad.  It's lovely, and you know I'm puking and gagging.

Apparently since Kool Smiles is involved in multiple lawsuits for abusing children, and they are trying to unload this company to some Private Equity firms, they have decided to put out updated propaganda.

The two little happy face o's jump out of the Kool Smiles logo and take you one a whirl-a-way adventure through a Kool Smiles clinic.

"Fun way to keep your family's teeth healthy"

"Our office is built for the whole family, especially kids." as children slide down an indoor slide and climb all over a play yard.

"Plus, everyone is friendly, not just us. (speaking of themselves, those jolly little o's) If you want mommy can come back with you or watch through a window," showing the tiny port hole only allowing direct sight of children in they hygiene area. 

Do you want strangers gawking at you through a window while you get your medical treatment done?  Hell NO!

"We see everyone in the family, even kids as young as one," they boast. 

Yes, those one year olds where they drill and cap all 8 teeth they have just in case they might get some decay between 1 and 6.  Prevention you know.

"If you want quality dental care, in a clean, safe and fun environment, come to Kool Smiles."

It's just an ad folks, still stay far far away.

Thursday, September 16, 2010

Dental Licenses Expired, No Problem!

Last week I shot off an email to a state dental board bringing to their attention and looking to filing a complaint about a dental facility whose licenses had expired over 2 years ago.  The facility has been in operation for years.  Its doors have never closed, and they are treating patients as I write this post.

Here is the response I got:

"You are correct in that the facility license has expired and we therefore do not have jurisdiction over this facility.

 

Can you believe it.  If the state dental board does not have jurisdiction after a licenses expires then WHO THE HELL DOES! (I'm not just yelling, I'm screaming!!!!)

So if a dentists license expires, and he/she continues to practice dentistry, no worries in this particular state.  You're good to go!

What a screwed up mess! 

Yes, ladies and gentlemen, the state dental boards are there to protect you!  As is evident in the letter I mailed (snail mail) to the Kentucky Dental Board in April and have not heard one word, not had one question answered!  Kentucky state legislators don't give a shit either, I didn't get a response from any of them either.

Yet these lawmakers will sure show up to a grand opening for a photo opt at a dental mill who abuses children won't they?  This happened just months ago in Louisville, KY and in less then two months complaints were coming in, and law suits have been filed. 

Where are those lawmakers now?  Hiding, that's where!

Open Letter To Kentucky Dental Board

Thursday, September 09, 2010

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?  

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. 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?

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.