January 2011
A new force in dentistry is being created by Carlyle, the US private equity group, which has bought two of the biggest UK dentist chains and merged them into a group with almost 450 practices.
Carlyle said on Friday it would acquire Integrated Dental Holdings from the private equity arm of Bank of America Merrill Lynch and merge it with Associated Dental Practices.”
I was reading the Top 50 Game Changers over at Dental Town and Corporate Dentistry made the list, as did Sedation and Sleep Medicine. 
I know I'm not the only one to notice, nobody says they "own" the clinics anymore.
I've made a complete copy of their blog accessdentistry.blogspot.com. There is not one word there that says anyone owns any clinic. Everyone is always a "lead dentist". Well, until it comes to the income, then FORBA wants to claim that, or the lawsuits, then those lead dentists suddenly become owners. Cracks me up sometimes.
Even in the local news video they posted, no own is introduced as "owner" of the Small Smiles clinic here in "fill in the name of the city".
All these Small Smiles dental clinics are either "affiliated with" or "associated with" Arcapita or Church Street Health Management, aka FORBA.
I'm sure they all hate the fact those initial press releases when Arcapita "purchased" these clinics were wiped off the web, sorry guys.
I get what they are thinking, they don't want their name on documents like this.
As you can see, and everyone working for Small Smiles and Church Street Health Management should take note of, everyone will be named in lawsuits.
The cost of hiring an law firm to initially take the case will be very expensive. Responsible or not, you've been named in a lawsuit. Everything for you changes at that point. And I mean everything!
Think your family won't be effected, wrong. Think your kids won't be effected? Wrong.
Try going out on your own with a pending lawsuit hanging over your head. Try doing much of anything with this kind of lawsuit hanging over your head.
I hope everyone is looking over what kind of documents you've signed.
Church Street Health Management (CSHM) is not going to protect you from the above. They are hanging you out to dry, in the end, you will be in this all alone.
Everyone will need their own attorney. Don't be stupid and think FORBA aka Church Street Health Management (CSMH) and their vast number of law firms and attorneys are going to protect you. Look out for yourself.
If you work for Small Smiles and Church Street Health Management, I would think you can expect to see your name on one of these someday in the future.
For those at other dental mills, be taking notes.
Boo! Run!
Tens of thousands of patients are extremely upset tonight as they have lost hundreds of thousands by the sudden, unexpected closing of Allcare Dental.
Patients showed up at Allcare dental centers across the country this week only to find the doors locked. A phone call to the company returned nothing but a busy signal.
Patients are furious and have been told that unless Allcare were to file bankruptcy it is unlikely they will recover their money.
Allcare Dental and Dentures' Better Business Bureau rating had dropped to a D- in the last few months.
Heck, that's nothing, FORBA Holding and it's Small Smiles Dental Centers rate F.
This is why you never pay for services until rendered and another example on why these drive thru dental and denture clinics must NOT be allowed. State dental boards must get off their tuchus and enforce the laws on the books. The laws are there for a reason, and this is one of them.
The closing was suddenly announced without warning, leaving employees in shock. The announcement came on New Year's Eve of all things.
It flat ran out of money.
I'm sure it had nothing to do with the poor quality of care and thousands of complaints.
They even shut down their website. However they did set up allcareinfo.com to assist patients they left hanging.
One down, hundreds more to go. I can remove those files from the file cabinet. However, will still be tracking their dentists for complaints.
Altair Customer Intelligence is pleased to announce the continued partnership with Church Street Health Management for 2011. Altair has been providing Church Street Health with strategic database marketing and consulting insight for the past two years. By using Altair’s FiveStar™ process, Church Street Health has leveraged industry leading analytics, modeling, and reporting techniques to sustain continued market growth for their network of associated Dental Centers and improved marketing resource utilization.
“Our mission is to ensure access to quality, professional dental care for low-income, underserved families and those seeking comprehensive care—and we’re better able to do that with Altair,” said Mike McCulla, SVP, Marketing, Church Street Health. “Altair provides the information we need to more effectively maintain our existing customer relationships, and identify and reach out to additional children and their families. Altair is a vital part of our business.”
Under this agreement, Altair continues to deliver a comprehensive solution providing data, selection, modeling, and customized access using its proprietary multi-sourced consumer database that contains 1,000 different data elements on 200 million consumers supporting Church Street’s prospect acquisition. This allows Church Street to select, analyze and review targeted prospects knowing that their marketing efforts are based on informed decisions with the most accurate data available.
According to Steve Collins, President of Altair Customer Intelligence Analytics Division, “This is a deep relationship that continues to grow and contribute to Church Street’s marketing success. Our data, speed, and flexibility is what sets us apart. We are thrilled Church Street has chosen Altair as their partner.”
About Church Street Health Management
Church Street Health Management assists children and families in accessing dental services in areas that have historically had limited availability of dental providers. With an associated network of 72 Dental Centers in 22 different states and the District of Columbia they ensure that more than 700,000 children a year receive the dental care they deserve.
http://www.cshm.com
About Altair Customer Intelligence
Founded in 2001 and led by veteran direct marketers, Altair has become the leader in Customer Intelligence, providing superior direct marketing resources through better access, analysis, strategy, and reporting. Altair is dedicated to helping businesses get more from their marketing investments by supporting extraordinary companies through a better use of Customer Intelligence for more informed decision-making. Altair has developed an expertise in helping companies gather, analyze, and use internal and external data to make better business decisions. Their extensive industry and marketing expertise gives customers unfettered access to information for improving their business and marketing goals.
More information is available at http://www.altairci.com
Small Smiles parent company changes ways, name following scandal
Nashville Business Journal - by April Wortham
Date: Wednesday, December 29, 2010, 2:34pm CST
Management at FORBA Holdings LLC say the Nashville-based dentistry company has changed its ways. It is also changing its name.
- April Wortham
- Reporter
- Email: awortham@bizjournals.com
Beginning Jan. 1, FORBA becomes Church Street Health Management, a reference to the company’s corporate headquarters at 618 Church Street.
Senior Vice President Todd Cruse said the name change better reflects the company’s “overall purpose and mission” of providing dental care to underserved communities. FORBA operates 68 Small Smiles Dental Centers in 22 states, none of them in Tennessee.
In the last 12 to 18 months, FORBA has expanded beyond providing dental services to children and now treats adults, Cruse said. Its also has begun offering other lines of oral health treatments, including oral surgery and orthodontics, and has struck up relationships with outpatient surgery centers for more complicated procedures, he said.
The name change is also a fresh start of sorts for FORBA, which in January 2009 agreed to pay $24 million over five years to settle charges that it billed Medicaid for unnecessary dental procedures on low-income children.
The name changed was filed today, in Colorado, December 23, 2010 at 2:24PM
I've noticed a lot of ads in the past few months have the phrase I've highlighted. "Operating as" Sounds to me that is only the first part of the phrase, the omitted ending would be "but not really". I just love how creative they get with their wording. They imply they are operating individually knowing they are not.
lol
Ad for Dental Assistant in Muncie, Indiana
Small Smiles Dental Centers, the nation's most experienced dental provider to children who qualify for government insurance and has been named one of Fast Company Magazine's 2007 Fast 50 Companies doing good in the world. We have over 60 dental centers in the United States operating as individual practices where each team member takes our mission seriously. In order to accomplish that assignment we must hire great people! And we have an excellent opportunity for an ambitious DENTAL ASSISTANT to grow our state-of-the-art dental center.
When Corporate sends the list of 10 “random” case files for their audits, here is what to do:
Step 1 - Pull the charts.
Remember, Corporate already knows exactly which charts to pull as they get a report every day on who was treated, what was done, why treatments were done, or why patients did not wait to be “converted” from Hygiene to Operative, etc.
Every day, they know how many appointments were scheduled and how many canceled. They know what patients they saw, how many crowns were placed on each patient and who treated the patient. I am sure they know where the treatment took place (i.e. the OR or clinic). They know if treatment was not completed and they know why.
Each day, Corporate knows how many patients are on the appointment schedule a month or more in advance. It is all in the computer. It is even broken down by the department; the exact number scheduled for Hygiene\Operative\ and the Total, no doubt. After all, this is a For-Big Profit organization. Clinics and the employees within are answering to a “higher power” and it is not a divine being.
- Actual revenues for the week
- Who was off from work that week or day and why
- Number of customers that week, in this case patients.
- How many were new, how many were reschedules, how may kept their assigned appointment, how many did not.
- Amount of supplies used and the difference from what was budgeted.
- How many morning “huddles” for the week, who was there and who was not.
- The number of returns, in this case redos.
- Likely to include customer comment cards, the good ones, as the bad ones get tossed.
- Any new hires, any fires.
- Problems that need to be address, such as Nitrous Oxide levels too high in the clinic. Those sort of things.
Step 2 - Immediately print out the account information on each chart pulled.Step 3 - Make photo copies of everything in the chart, include a copy of the x-rays.
Step 4 - Give to the HBIC (Head Bitch In Charge).
Step 5 - HBIC will review each file to make sure everything documented in the chart matches what the computer said was done to that patient
HBIC makes sure if the computer statement said tooth A (upper right baby tooth) but the chart said it was tooth M (lower left) that entry was corrected.
But which was true? Without recalling the child for a look-see, who actually knows.
If they do not match, make them match. Either by rewriting the treatment plan or correcting the record in the computer.
Maybe they will make a note to check the actual child when he or she comes back for the next visit and it will be corrected again, then maybe it will not even be checked and life goes on.
How can the chart be changed, you ask?
It is only my opinion, I would say, adjust the chart would be much easier since the account has already been billed out and you would have to add to the billing or make other billing corrections. So chart changing might be the best choice.
With such a high turnover at these places, it seems it would be difficult to correct chart notations to match the original hygienist, dental assistant’s and dentist’s notations.
Maybe the best would be a whole new document.
Except when one forgets, that the new handwriting belongs to a new employee who was not there when this patient was seen, but who is going to look at that, right?
If the original employee is still there, the HBIC could just approach the hygienist, assistant or associate dentist and threaten them with their job, if they do not fill it out or at least sign the new and improved treatment plan and charting. Talk about being put on the spot, it is not like the employee would have a couple of days to think about it. After they sign it, what do they do then? You do as you are told if you want to keep your job, feed and clothe your family and keep a roof over your children’s head.
Maybe you also forgot to have the parent sign the treatment consent form. What about the “It’s Ok To Strap My Child Down, Man Handle Them, and Send Them Back To Me Covered in Puke and Urine” form. Ooops.
That would be easy to correct, especially if they have the parent’s signature on other forms. Just trace it, right? not send it.
Again, who is going to check?
Of course, there are times when things are crazy in the clinic and treatments completed will get left off the chart. But how did the treatment get on the computer account if it was not charted? Hmmm…
The dentist is supposed to review the chart of the patients they saw at the end of the day. Ideally, the dentist should be doing a quick review of the chart immediately, as the patient is being cleaned up and walked out.
I think it would be good, to do as my doctor does and as soon as he steps out of the room with my chart in hand, out comes his recorder and he immediately records in his very own voice what treatment was done, what diagnosis was made and when he wants me back.
Mistakes happen and agreed, many of the assistants are not trained and most likely worked at the local 7/11 last week.
Step 6 - The copies of the charts are put into a Fed-Ex package and shipped off for analysis. In about a week or so, a grade is handed out, just like in school, and points given toward your bonus for doing such a marvelous job.
I bet if you can ask, the office staff will know how well they do on chart audits, and whether they are at the head of the class or sucking hind tit.
Of course this is no way to do a chart audit. The Regional Manager should be doing this, if he had a clue what he was doing and not a former mortician or something.
Better, would be the company Compliance Officer off his or her ass or Assistant Compliance Officer, if there was one, to fly around from clinic to clinic and do the audits. What about an outside objective party do the chart audits?
Surprise visits are the ticket to proper chart audits. An auditor marches in, briefcase in hand, and start pulling charts.
When chart audits are done in this manner it means nothing when told how fantastic Compliance is within the company, in fact, it is laughable.
I have heard FORBA has an in-house specialist on this matter. They may even give “webinars” on the best possible signature forging technique. Who knows. I guess you could just leave that document out and
In February 2008, just months after Arcapita, American Capital Strategies, Carlyle Group, CIT, Michael Lindley, Al Smith and others bought all the assets of the Small Smiles Dental Clinics from the DeRose "family", the American American Academy of Pediatric Dentistry (AAPD) was awarded $10 million dollars and a 5 year contract to manage the newly created Head Start Dental Home Initiative.
Don't tell me this had nothing to do with the sudden surge of dental mills across America. Of course it did.
In 2009 the AAPD hired a huge PR firm, the MWW Group, to drive home the importance of pediatric dentistry.
In June 2010, the AAPD received the Award of Excellence from the 2010 Associations Advance America Awards program. This AAAA sounds a bit sinister to me. Sounds like an award for their success in being hijacked or something.
By November 2010 the Office of Head Start notified the AAPD their services were no longer needed and would be taking control of the Head Start Dental Home Initiative.
Did we get our money back?
Thoughts?
A wonderful letter from a dentist who is very concerned about the state of dentistry in Massachusetts. I hope they don't mind that I shared this.
Dear Debbie,
I hope this e-mail finds you and your loved ones in good spirits and good health.
Over here in MA the state dental board passed a host of new dental laws and regulations this past August. While there are a few new laws that at least give a nod towards promoting public safety, when I read many of the laws, I saw many regulations written with dollar signs in mind.
Three of the laws (Public health center, dental director, and public health hygienist laws.) will further entrench the unscrupulous Medicaid mills already present in this state. On top of this horror, a host of sedation laws will allow dentists to be, for all intents and purposes, anesthesiologists.
Deep sedation, whether one is working on the heart or in the mouth, functions the same in both patient populations. In other words, although the specific purposes are different (heart surgery vs dental work), the physiological mechanism is the same, and the risks are the same. Unfortunately, these risks involve death and/or brain damage.
Where things are now different in this state, and where things have gone horrifyingly awry, is that with a brief (and expensive, of course.) period of training, some of my colleagues will be able to place patients under deep sedation. In medicine, MD anesthesiologists and nurse anesthesiologists must go through a rigorous residency program lasting for years. (4 years for MDs and 2 years for nurse anesthesiologist practitioners.)
On a functional level, medicine has recognized that it is better to have a specifically-trained person in a proper setting to perform anesthesia. Medicine recognizes that it's not a good idea for the surgeon to try to sedate the patient, monitor the patient's life signs and breathing, and also perform surgery. The only "positive" side to this hypothetical medical scenario is that the surgeon could make out like a bandit by doing everything him/herself.
Debbie, my deep and abiding fear is the day when the new dental mill-enabling laws in this state converge with the new sedation laws in this state. Imagine what Small Smiles would do with a state-sanctioned sedation carte blanche. Now, it's only a matter of time before the carnage starts. Kids shouldn't die for the profit margins of the ruthless. Goddamn them.
Please be well Debbie.
Sincerely,
M
Meridith L.
Posted 05/15/2010
As a person who had a root canal done on a papoose board as a 3 year old, please do not have major dental work done on your child without general anesthesia or conscious sedation. At 30 years old, I still have nightmares about the experience and have to be sedated for even the most routine work. At 3 years old, I couldn't tell the dentist that the numbing medications were not working and that I could feel every second of the root canal. They dismissed my crying as fear and not true pain.
Find a dentist and an anesthesiologist who you love and trust and who will let you be there with your child so that it is calm, peaceful, and a good-as-the-dentist-can-be experience for your child.
Bad, painful, and scary experiences now can lead to a lifetime of fear, trauma, and distress, but good experiences can lead to a healthy smile, good oral hygiene, and improved overall health.
Looks like we have another change of faux ownership for the Youngstown, Ohio clinic. Yes, it’s true! I know, amazing, right? This is the clinic who had the idiot dentist fall asleep during a procedure.
I know, I know, he says he was dozing while the assistant was doing something, but that assistant says that is a total lie! I believe the assistant.
The latest foolish dentist to add his name to the Secretary of State’s LLC documents as “owner” of this clinic is….
drum roll please….
Dr. Michael Crites!
Dr. Michael Crites should know better by now, he’s been there for just over two years. Maybe being “owner” is his reenlistment bonus. If so, it is NO bonus! It’s more like putting your head in the guillotine.
However, Dr. Crites is no stranger to the Ohio dental board. There are 16 pages of “actions” against him. That explains why he fits right in at Small Smiles of Youngstown.
I find it hard to believe (no I don’t) that he has credentials with any state or and especially any company that manages Ohio’s Medicaid Dental Program. Geez!
History of this clinic
First registered as an LLC in Ohio February 2007, Joseph Bower the authorized representative, (Agent). Name- Small Smiles of Youngstown, LLC –Kenneth E. Knott, DDS and Robert F. Andrus, DDS.
Knott and Andrus were “fired” because Kallene West (also let go) was taking their CE’s for them. However FORBA didn’t have a problem with Kallene taking the CE’s for Dr. Bridgett Merritt-Brooks. Dr. Bridget is still working her little fingers to the bone in South Bend. In my opinion Dr. Bridgett is practicing without a licenses in Indiana…but heck, who am I to judge right? More on this a bit later.
Back to Youngstown:
Apparently Dr. Michael Crites can’t wait to be added to the next lawsuit.
Summary:
February 2007 - Small Smiles of Youngstown, LLC- Dr. Robert E. Knott and Dr. Kenneth Andrus.
September 2007- Trade Name - Small Smiles Dental Clinic of Youngstown
September 17 2008- Small Smiles of Youngtown, LLC- Jodi Kuhn, DDS and Patricia Nicklas, DDS.
February 4, 2010 - Small Smiles of Youngtown, LLC – Jodi Kuhn and Olivia Croom, DDS
October 4 2010 - Small Smiles of Youngtown, LLC-Michael Crites, DDS
Where are those documents of the sale of this clinic?
Someone needs to send out the “Prove It” letter to Dr. Michael Crites.
Anyone, Bueller, Ohio Dental Board?
I live in Hickory, NC. I had heard about Tish Ballance on the news getting in trouble for Medicaid fraud, but did not remember her name. My son is 6. He went recently for a cleaning to a different dentist and they found a cavity. While I was waiting for his appointment, they did a free screening at his school which also detected a single cavity. When it came time to be filled, our dentist wanted to refer him to another dentist 30 miles away. i decided to find a local dentist that took Medicaid. i found Carolina West Dentist in Conover near my home. I took him there to Tish Ballance's new clinic for children with Medicaid. Just 2 weeks after 2 dentists had diagnosed him with a single cavity, she said he needed caps on 3 molars in addition to the cavity. That's when I checked into her office and found out she had been in trouble before. Beware of this office!!!
Will another parent going home today without their child?
In an attempt to assist state dental boards I have taken the lead of the Kansas Board of Dentistry and created a form letter. This letter is available for download and can be customized as needed.
You can download the free “Prove It” document by clicking here.
If any boards need assistance in who should receive these letters, please email me, I would be more than happy to provide that information if available.
You are most welcome,
Debbie Hagan
PS. You may also copy and paste from this blog post:
Here is a form letter designed to assist state dental boards with investigations of corporate owned dental clinics operating under the disguised of being dentist owned clinics. Such as Aspen, Kool Smiles, Small Smiles, Dental Dreams, etc. It can be customized to fit your needs.
[State dental board letter head]
Dear Dr. [dentist name here]
The Dental Board requests [dentist’s name inserted here] provide a written response explaining how your association with [corporation name i.e. FORBA] corporation is not creating a violation of the dental practices act of the state of [enter name of state], specifically, [enter state practice act number and section forbidding or limiting corporate dentistry].
In the written response, we respectively request you provide all of the following:
1. A copy of your purchase agreement or ownership documents of the clinic.
2. An employee handbook.
3. A copy of advertisements published to hire dentists or other employees.
4. If a PC or LLC provide a list of all member with % of ownership interests. Include address and all contact information for the members and a full copy of your “Operating Agreement”.
5. An Operating Agreement or Contract between yourself and [enter the name of the corporation in question] showing the services they provide and the cost to your practice.
6. Attach your personal and business FEDERAL, STATE and LOCAL income tax returns with attachments, including Schedule C with W-2’s or 1099’s. If you are a PA, PC PLLC or LLC include returns for you personally and for the business entity.
7. Attach five payment reimbursement forms from Medicaid and five from insurance companies.
8. Attach copies of promissory notes or loan agreements with amortization schedule used.
9. Attach a copy of the last 6 bank account statements for the business.
10. Attach a copy of your last three Federal 941 forms and copies of checks included with Federal form 941. Include copies of checks if you made periodic payroll deposits. Include copies of the last three 941-V vouchers, if any.
11. Attach copies of your last three Federal 940 FUTA forms and copies of checks showing payments made.
12. Include copies of checks showing all of the following payments:
· Building and/or Equipment loan or leases
· Employee payroll
· Utilities
· Liability Insurance
· Malpractice Insurance and Workman’s Comp Insurance
· Insurance on building and/or equipment
13. Do you own the fixtures and equipment? ___ Yes ___No
If “No” state from whom it is leased:
Business Name:________________________
Contact Person: ________________________
Address:_______________________________
Telephone:_____________________________
If “Yes” include copies of checks showing local/state personal property tax.
14. Do you own the building? _____Yes ____No
If “No” state from whom it is leased:
Business Name:_________________________
Contact Person”_________________________
Address:_______________________________
Telephone:_____________________________
15. List dates of employment, names and contact information of all dentists, hygienists, and dental assistants employed by the clinic.
16. Provide a copy of your EIN application.
17. If you own or operate more than one clinic, provide the legal name and dba name of each clinics, as well as its physical location include ALL states.
Please add the following statement, sign and date:
“I attest the above to be a true and accurate statement including all attachments”
Provide the above information within ten(10) days from the receipt of this letter.
Sincerely,
[Signature of Investigator]
Stainless Steel Crowns – Hats for teeth
Papoose Board – Blanket
Pulpotomy – Medicine for the tooth
Guaze – Band-aide
Blood – Heme
Shots – Sleepy juice
Needles – Needs
X-ray – Taking pictures
Fluoride – Vitamins
Tylok Dental Cement– Glue
Etch – Soap
Small Suction – Mr. Thirsty
Large Suction – Vacuum
Curing Light – Tooth Dryer
Extraction – To wiggle out the tooth
High Speed Drill – Mr. Whistler
Slow Speed Drill – Mr. Bumpy
Bite Block – Pillow for sleepy teeth
Amalgam – Silver stars
