Kool Smiles Said to Have Received Offer of $700 Million Clinics

Oct. 4 (Bloomberg) -- American Securities LLC, a New York- based private-equity firm, is the leading bidder for a U.S. chain of dental clinics owned by Friedman Fleischer & Lowe LLC with an offer of about $700 million, according to people with knowledge of the auction.

Friedman Fleischer owns two companies, NCDR LLC and DPMS Inc., that provide facilities and support staff to dental groups operating under the Kool Smiles brand, according to the San Francisco-based firm’s website. TPG Capital also submitted an offer in the final round of bidding, said the people, who asked not to be identified because the deal hasn’t been completed.

The two companies are not really two companies, it's Kool Smiles and Kool Smiles 2.  KS is the clinics in the East and KS2 are the western most clinics.

Read the full article here: Business Week

However since after time passes and the stinch of a company begins to fill the offices of these PE firms, stories like this seem to vanish from the Internet.  So in case that happens, here is the full story:

By Cristina Alesci, Jeffrey McCracken and Jason Kelly

Oct. 4 (Bloomberg) -- American Securities LLC, a New York- based private-equity firm, is the leading bidder for a U.S. chain of dental clinics owned by Friedman Fleischer & Lowe LLC with an offer of about $700 million, according to people with knowledge of the auction.

Friedman Fleischer owns two companies, NCDR LLC and DPMS Inc., that provide facilities and support staff to dental groups operating under the Kool Smiles brand, according to the San Francisco-based firm’s website. TPG Capital also submitted an offer in the final round of bidding, said the people, who asked not to be identified because the deal hasn’t been completed.

Rajat Duggal, a managing director at Friedman Fleischer, couldn’t be reached for comment. Officials for American Securities and TPG declined to comment.

Private-equity firms have resumed dealmaking after a two- year lull following the global financial crisis that started in mid-2007, freezing credit markets and ending the biggest leveraged-buyout boom in history. There were $59 billion in deals in the third quarter, more than triple the amount a year earlier, according to data compiled by Bloomberg.

American Securities, which was founded in 1947 by a Sears Roebuck & Co. heir, has invested in companies including vacuum- cleaner maker Oreck Corp. and the El Pollo Loco chain of chicken restaurants, according to its website. The firm was a runner-up at the recent sales of Air Medical Group Holdings Inc. and Aspen Dental Management Inc., both owned by private-equity firms, according to a person with knowledge of the sales.

Air Medical, Aspen Dental

Leonard Green & Partners, the Los Angeles-based private- equity firm, is buying Aspen Dental from Ares Management LLC. Bain Capital LLC, the Boston-based leveraged buyout-fund manager, is acquiring Air Medical from Brockway Moran & Partners Inc. and MVP Capital Partners.

Kool Smiles caters to children enrolled in Medicaid, a federal-state health insurance program for the poor, and other state health insurance plans, according to Friedman Fleischer’s website. Some firms that looked at Kool Smiles were concerned that it was too reliant on Medicaid payments as governments face deficits, said one person familiar with the auction.

Private-equity firms are increasingly buying companies from each other as more than half the companies that submitted plans for U.S. IPOs in 2010 have yet to complete them. Sales among buyout firms allow the seller to return cash to investors, while the acquirer is able to deploy unused capital that was raised during the boom. Clients saw distributions last year fall to the lowest level since at least 2000, according to London-based research firm Preqin.

Opening Clinics

Smile Brands Group Inc., a separate dental chain backed by private-equity firm Freeman Spogli & Co., scrapped an initial public offering in May. The company, which relies on patients with private insurance for most of its revenue, is now shopping itself in a sale process that is still in early stages, according to a person with knowledge of the matter.

American Securities plans to expand Kool Smiles’ main business of opening clinics in places where access to dentists and other medical services is limited, the person said.

TPG has been pursuing deals. The Fort Worth, Texas-based firm and Goldman Sachs Group Inc.’s buyout arm agreed in July to purchase Belgian diaper-maker Ontex NV for $1.55 billion from London-based private-equity firm Candover Investments Plc. TPG also acquired a 35 percent stake in Creative Artists Agency for an undisclosed amount in a deal announced Oct. 1.

Friedman Fleischer has more than $2 billion under management, according to its website. Its holdings include Korn/Ferry International, the executive-recruiting firm, and Montpelier Re Holdings Ltd., a Bermuda-based property reinsurance company.

--Editors: Elizabeth Wollman, Larry Edelman
To contact the reporters on this story: Cristina Alesci in New York at Calesci2@bloomberg.net; Jeffrey McCracken in New York at jmccracken3@bloomberg.net; Jason Kelly in New York at jkelly14@bloomberg.net.

Tennessee Case - National Union Fire Insurance of Pittsburgh v. Small Smiles Holding Company Update - September 30, 2010

Case Number 3:10-0743 filed in United States Federal District Court Middle District of Tennessee – Nashville Division

Small Smiles Holding Answer to the Complaint filed by National Union Fire Insurance Company of Pittsburg.  NUFIC is a Subsidiary of disgraced AIG, American International Group.

Judge Joe Brown recused himself; no reason was given.

Order after Judge Brown recused himself, by Judge Juliet Griffin

Small Smiles Corporate Disclosure Statement- It has no parent company and American Capital Strategies, LTD owns more than 10%.  Small Smiles Holding is the parent company of FORBA Holding, LLC.

Joint Case Management Order – This document states an over view of both sides of the case as well as the court's calendar.

 

November 9, 2010 – Deadline for Small Smiles Holding to file a Counterclaim against National Union Fire (AIG)
January 31, 2011 – Deadline for Small Smiles Holding Company to file third-party claims under Federal Rules Of Civil Procedure 13.  Join additional parties under rule 14.  Join additional parties under rule 19 or 20.
January 31, 2011 – Last chance to amend pleadings under Rule 15.

Discovery Schedule:

October 15, 2010– AIG's National Union Fire Insurance Company of Pittsburgh and Small Smiles Holding Company to make initial disclosures of their respective evidence.
February 18, 2011 - Discovery related to motions, except those dealing with "experts"
March 18, 2011 - All Fact Discovery and Discovery related motions are to be completed, except those related to experts. AIG's National Union Fire Insurance Company of Pittsburgh and Small Smiles Holding Company may each serve 50 Interrogatories, which includes all subparts questions.  If they need more, they mutually must agree.
March 30, 2011 – Deadline to ask the court for a Settlement Conference if they decide on an attempt at a settlement in the case (and the FORBA bunch usually settle or dismiss.
April 15, 2011 - AIG's National Union Fire Insurance Company of Pittsburgh  must disclose their expert witnesses and any reports from the experts.
May 16, 2011 – Small Smiles Holding Company has to disclose their expert witnesses and reports from those expert witnesses.
June 30,2011- Depositions of the "experts" must be completed.
July 29, 2011 – Deadline for Motions/Objections to be filed by either party in relation to the depositions taken and the opposing party has 45 days to respond to any Motions/Objections.  Parties have the option to file briefs within 29 days of any response.

Monthly case management conferences are scheduled to address issues National Union Fire Insurance (AIG) and Small Smiles Holding Company are unable to resolve among themselves.

January 9, 2012 – Deadline for parties to file objections to expert testimony and motions in limine.

Trial by Jury Date Set for January 31, 2012 by Judge Todd Campbell; it is slated to last 10-14 days.

 

For Reference – Federal Rules of Civil Procedure (Fed. R. Civ. P.)

Access West Dental, Asheville, NC-Dr. Letitia (Tish) Ballance

I don't know how old or new this ad is but here is an ad for a job listed at ncdental.org for a new graduate dentist and dental assistants and more.

Access West Dental-Asheville, NC-Dr. Tish Ballance, DDS.

Does Letitia (Tish) have her hand in the cookie jar again and looking to physically and mentally abuse more children in North Carolina? If so, as it appears, who is she in bed with this time. I would think she would want to be more than transparent in her new ventures.

I found an article written back a few years, November 2004 I think, talking about how Tish Ballance had been raised in North Carolina, and instead of going into a normal practice as a dentist she wanted to help the poor children in North Carolina by opening her heart and dedicating her life to helping those children of North Carolina, yeah right, Tish. Sounded good at the time didn't it.

From what I can gather it's scheduled to open in July 2008. Interviews were scheduled for these positions on Saturday 4/12/o8 at the Marriott Residence Inn on Biltmore Avenue, according to career builder website.

Now I'm not that educated as most can tell from the half hazard way this site is thrown together but if I had just gotten named and fined with a cohort, Michael DeRose, 10 million dollars, 10 MILLION DOLLARS I don't know that I would still be out trying to do the same thing again with in 2 days! Then again, maybe I'm just a quick study and some people just aren't.

As you can read from the ad, once again it's a newly formed "group", wonder exactly who is involved in the "group".

Is it just me that finds this just amazingly stupid! Change names, change locations, rinse and repeat!

Honestly those with a sense of humor, you gotta just love this one!

ACCESS WEST DENTAL (Asheville, NC) - Great opportunity to live, work, and play in the beautiful mountains of western North Carolina in the progressive Asheville area, earn a great salary with no administration responsibilities, and to dedicate your skills to making a real difference! Join Access West Dental opening soon in Asheville, North Carolina. The newly formed Access West Dental is a private group general dental practice that will concentrate on providing much needed access to quality dental care for the under served children and young adults of western North Carolina. The new state of the art 10,000 sq foot office is presently under construction in west Asheville and will boast a beautiful professionally designed spacious interior, 8 chair fully computerized open hygiene bay, digital radiography throughout with intra-oral cameras, and 10 fully computerized ops to also support the “paperless” office model. In addition, there will be a central sterilization area, 4 private consultation rooms for discreet and informed doctor/patient communications, and a full complement of trained support staff that will consist of 4-5 RDHs, 10 DAs, 5 front desk staff (2 bilingual), plus and office manager and a director of operations. The practice will be open Monday -Thursday, closed a full day on Friday and offers a very competitive guaranteed salary and full benefits package for only a four day work week. New graduates encouraged to apply! Please contact Dr. Tish Ballance at 828-665-4410 or accesswest@gmail.com for more information on this practice opportunity.

Smiles Starters North Carolina Still Delivering Overtreatment to the Underserved via Elysa Bailey de Morias, DDS

Thousands of complaints made on Internet "message" and "review" boards.

Hundreds of legitimate complaints filed. 

At least 8 lawsuits.

Ten Million dollars ($10M) in restitution to the government for fraud. 

Under observation since 2003. 

Under my watchful eye since 2007.

Name changes of the facilities.

North Carolina State Board of Dental Examiners spending hundreds of hours reviewing complaints on former owners, current owners, past employees, current employees. 

Warning after warning issued, Consent Orders for Disciplinary Actions passed out like programs at a school play.

Surprise inspections from state and federal agencies.

It is almost October 2010 and we still we have Elysa Bailey de Morias, DDS.

Elysa may well be a very nice person, there are a lot of people who are stupid and/or crooks. 

 Here is the Compliant and Consent Order for Dr. DeMorias

Highlights

Practicing at Smiles Starters in Greensboro, North Carolina

A three year old girl was seen by Dr. Elysa on November 3, 2008, we will call the child HW.

Dr. Elysa “was unable to conduct an adequate visual clinical exam or take sufficient radiographs to support her treatment plan.

Dr. Elysa decided to develop a treatment plan anyway that consisted of restoration of 6 of HW’s teeth, “with possible stainless steel crowns on three of her teeth.”

Dr. Elysa placed “watches” on six of HW’s other teeth. That should be about all the three year old had in her mouth. Looks like Dr. Elysa was going to get at least ½ of them.

HW’s mother felt this was not right and took her child to a second dentist the very same month.

The second dentist wasn’t able to perform a through examination on HW.

In June 2009, 7 months later, HW’s mom took her to the second opinion dentist again who then was able to perform a full and comprehensive assessment.

All the second dentist found, 7 months after Elysa de Morias of Smile Starters saw this child, was a discoloration on tooth A and a minor fracture in the enamel of tooth N. He found NO decay on ANY of the teeth Dr. Elysa de Morias has supposedly found 7 months earlier.

In November 2009, more than a year after Dr. Elysa de Morias wanted to drill away and put stainless steel crowns on 6 of HW’s teeth, HW was seen by yet a third dentist. Dentist three found the very beginning decay on tooth A which he felt probably was not there a year earlier when Dr. Elysa laid claim to a mouth full of restoration needed, but found no other tooth problems what so ever.

All the Board nailed Dr. Elysa for was “violating the standard of care for dentists licensed to practice dentistry in North Carolina by proposing a definitive treatment plan without having conducted an adequate clinical examination and sufficient radiographs.”

Dr. Elysa de Morias agreed that there was sufficient evidence against her, but did not admit any wrong doing but decided not to oppose the allegations and agreed to whatever the Board decided to hand out as punishment.

Elysa Bailey de Morias, DDS has her dental license suspended for 30 days. For the next 2 years she must:

Not do that anymore

Not direct her employees to do that anymore

Allow random inspections and interviews

Complete continuing education designed especially for her at the North Carolina School of Dentistry

Reimburse the board $650.00 for their time and trouble.

Have her name reported to the National Practitioner Data Bank (which is no big deal these days).  Former owner and rumored to be current financier, Dr. Michael DeRose was put on that list many years ago and kept his licenses until 2009!  As did his partner in crime, Dr. Tish Ballance-she is still practicing.

Dr. Elysa Bailey de Morias has been in operation in North Carolina since September 2007!  Imagine the number of underserved she has overserved.

The Possibilities

I'm sure I've missed some billing codes and this isn't exact, but it sure is close.

North Carolina Reimbursement rates:

D0150 – Comp oral evaluation - $44.61
D1120 Prophylaxis (aka cleaning)- $27.21
D0210 Intraoral-complete series w/bitewings $71.79
D1203 Fluoride $16.04
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77

Total - $2339.99

If the procedures was upcoded to the D3230/D3240 it would be an additional $50 per tooth totaling just over $2600.00.

It's not uncommon to upcode the pulpotomies (D3220) to pulpal therapy (D3230/D3240).

D3220 - Pulpotomies are performed on vital teeth, while pulpal therapy (D3230/D3240) is performed on necrotic primary teeth, with resorbable medicament placed down the canals.

Conclusion

The only conclusion I can come to is Dr. Elysa de Morias  unnecessarily tortures and mutilates children, defrauds the medicaid system and got caught this one time. 

However, all that happened was a slap on the greedy little hand and back to work. 

Nothing was mentioned about the full extent of her attempts, just the actions; “violating the standard of care for dentists licensed to practice dentistry in North Carolina by proposing a definitive treatment plan without having conducted an adequate clinical examination and sufficient radiographs.

Questions

As with all of these cases, we have to ask what caused a person who spent thousands of dollars for her education to attempt not only fraud, but needless suffering of a 3 year old child, and to do it as casually as taking her next breath.

How many patients does she see in a week, a month, that she tries and succeeds in this exact scam?

Why are dentist caught doing this not prosecuted?  Doing an investigation, slapping a seeming large fine on them, but letting them keep right on is doing nothing to stop it.  So I have to assume the powers that be support.

Why do support staff not report this? 

Does it make those in the office who turn their head just as guilty?

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.

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.

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.

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

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

Things FORBA Small Smiles Don't Want You To Know

In the past two weeks FORBA, for some reason,  after 2 years has decided they don't want anyone to see information or opinions of two subjects.  I received a letter last week asking two be removed and this week they've added a new one to the list.  Until it can be further investigated I will remove them, in accordance to the consent injunction I signed.  However, 2 years ago, I filed a Compliance agreement saying I had removed reference to documents they were stupid enough to post openly on the Internet.  Being they accepted that Compliance statement with no objections, seems to me I had satisfied their request, right?

However, they have decided to pick on me again, I guess I'm the only case in the courts they feel they can truly get a bit of satisfaction beating upon.  I find it amazing in so many ways. 

Here is a quote from their Cease and Desist Letter:

"…a review of recent postings on your website dentistthemenace.com which is directed to debbiehagan.blogspot.com, reveals that you are engaging in clear contempt of the Court's permanent injunction by publishing confidential and internal information about FORBA's contracts with its dentists.  Without limitations, we direct you to your entries dated July 13 … and 20… 2010…" 

I'm not sure how they consider their new deals with the dentists "confidential and internal" since there are ads out the waazoo on the Internet advertising they are hiring and dentists will be paid a commission.  But we know how they operate, put it on the Internet, and cry like a baby if someone who does not like them reads it!

Clearly their standard of "Confidential and Internal" differs greatly from what is normal, instead meaning anything they themselves post on the Internet.  With that being the stick by which they measure, how in the hell would anyone know what they consider "Confidential and Internal"!!??

As for all other lawsuits involving them, I actually have lost count! 

Ohio – 2, or three I think

Virginia – 3, I believe

Tennessee- 1

Oklahoma – 1

New York – Hundreds maybe, who knows

Colorado – untold number but at least 1 or 2 this year

South Carolina – 1, but I think it's settled

Anyway, you get the point…they have mucho legal proceedings going on and mucho legal fees.

Here is the response received from them yesterday.  Yesterday they added a new post they want removed.  I guess I could get one of their letters everyday seeing how they gauge "Confidential and Internal".  Looks like someone has a full time job and the postal service is going to love them!  However, I highly doubt they get another wish list filled.

Back to what they don't want you to know:

1.  Warnings and Pitfalls For Dentists - A post about problems working strictly on commission – After I reviewed this post in full I remembered this wasn't written by me but someone who saw several problems.  So I highly disagree that this information/opinion is or was "Confidential and Internal" to FORBA's business operations. 

2.  Small Smiles Dentists Pay To Be Production Based Only By January 2011-No Vacation-No Holidays-No Paid Time Off – Since this information are in ads Jenna Kochenberger has posted on the Internet, I highly disagree that this is "Confidential and Internal" either and believe they would have a hard time holding this argument. 

3. 126- The Number of Children Herded Through One Small Smiles Office in Just One Day – they don't want you to read this either. 

Anyway, we all know FORBA by now, whether it's being run by the DeRose bunch or the Arab bunch and their cronies they try to bully their way through, so bully it is.

They manhandle and bully the innocent children, they bully and imprison their employees, in my opinion of course,  so what else does one expect from the famous Bully Dental Company.

And by doing this, they just keep stuff that would have gotten lost in the mix, back to the top. 

GO FORBA! 

4 Year Old Tulsa Child Dead After Sedation At Pediatric Dental Group, Tulsa, Oklahoma – Charles Keithline, DDS! 4 Dead Children In 4 Months!

Is anyone paying attention to this issue. 

I'm thinking no. 

I hope someone takes this up and does NOT leave it to the Oklahoma Board of Dentistry,  they let citizens down every day!  Dental Boards fall far short on protecting the citizens of Oklahoma, but it's not just Oklahoma!

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:

Dr. Charles Keithline # 3942
Charges: practiced dentistry in an incompetent and/or negligent manner.
Action: 6 month suspension  and 5 yrs. probation. 

(I'm told it was due to drug addiction, but can not verify)
 

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.
**********

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

Hey Kool Smiles - Time For The Assistant With The Long Green Fingernails To Go! YUK!

Hopewell, VA 

Kool Smiles Complaint:

Me and my 6 yr old went to Kool Smiles because i was looking for a place to take us both for the convience. It was horrible for me and her. She had a dental assistant with 2+ inch fake green nails that she kept stabbing into my daughters mouth.

My experience left me with a sore mouth and a assembly line experience. Now I can't get them to stop calling me to schedule another appointment and sending me post cards. I have called and called and requested they remove all my information and told them the unpleasant experience we had and they are still calling my work and sending things.

 ATTN:  NCDR, LLC (Kool Smiles)

Clean Up Your Act! 

(I know, a pipe dream) 

Stop Calling People At Their Place of Employment! 

(I get this complaint a lot!)

New York Ocean Dental Complaint

This was posted in the comment section but thought it deserved some front page space.  Mr. Hoecker, do you have an comments on this! 

I took my daughter to Ocean Dental as it was difficult to find someone close to where I live that would accept medicaid.  They wanted me to watch through a window while they cleaned her teeth and did not let me go back for X-rays or the exam....then I was told after not being explained anything, showed x-rays, etc, that my daughter needed two fillings and a cap, she is 3 and a half, so I made an appt for the first filling, they kept pushing me to sign a waiver for laughing gas but didn't even give me time to read what I was signing, as there were so many people there I just did and that was a mistake, then I wasn't even allowed to stand in the hallway while they filled the cavity, after that someone did talk to me for about two minutes and said that I needed to make sure she brushed I said she does brush and I supervise, then the person said, "well you wouldn't let your three year old wash your dishes so why would you let her brush her own teeth," when that was over I took her out to the car where she proceeded to barf in the backseat and lean her whole body over to the side and said she didn't feel good.  I was so mad that I called there and complained, and decided not to go back, I took her to a far away dentist from my house and to my surprise they went over x-rays and showed me her teeth and proceeded to tell me that she had no cavities, I said well they said she needed another filling and cap and they looked again...same results....I am furious that this is how people are being treated just because they have medicaid..your not entitled a decent dentist unless you drive for at least 45 minutes?  These people need to be investigated in my opinion.....

OMG!

Ya Gotta See It

 

A Look At FORBA's Dental Lobbying In Massachusetts

FORBA Holding, LLC
Johnson Haley, LLP
51 Franklin St. Boston, MA  02110
617-778-1200     
                                                                              

Date	Amount	Expenses
1-1 to 6-30-2010	$54,469.00	No Exp.
	$750.00	To Todd R. Cruse
		Expenses were only $1500.00, that's pretty darn good net income for the first 6 months from one client.  Todd spent that on May 4, 2010 for a Delta Airline ticket ($1,500 and $400 for the Taj Hotel)
1-1 to 12-31-2009	$124,500.00	$818.70 expenses listed.  Another Todd trip in Aug. 2009.  $318.70 for same hotel and $506.20 for air.
1-1 to 12-31-2008	$112,500.00	No Exp.
1-1 to 12-31-2007	$ 96,000.00	No Exp.
1-1 to 12-31-2006	$120,000.00	No Exp.
1-1 to 12-31-2005	$65.000.00	Contact -Todd Cruse, 415 N. Grand Ave, Pueblo, CO  81003 tcruse@ddmktg.com
Total	$573,219.00

FORBA/Small Smiles Job Ad - Advertising New Contract Policy

Dentist

Forba - Washington, DC 20001

Forba Dental Network is currently searching for a skilled and compassionate Dentist to join our stable and successful offices in Washington DC and Oxon Hill, MD. For years, the primary mission of our offices has been to meet the dental needs of underserved children and young adults.  Dentists on staff enjoy a rewarding work environment without the administrative burdens of operating a practice.  You will have the opportunity to focus on quality care, while we handle the administration responsibilities.  You'll find a rewarding career with purpose, pride and passion when you join the team! 

We provide a competitive compensation and benefits package including Excellent Salary based on a percentage of your production,100% Health Insurance Premium Coverage (Employee & Family), 100% Malpractice Insurance Coverage, 100% Long-Term Disability Insurance Coverage, 100% Reimbursement for Continuing Education, Dues and Licensing Fees, 401(k) Plan with Match, Licensing & Credentialing Support & Relocation Reimbursement.

General Dentists & Pediatric Dentists are encouraged to apply. Please call Jenna direct at 719-562-4462, email jlkochenberger@forba.com, fax 719-584-7696 or visit our website at www.forba.com.

DDS or DMD
EOE

jlkochenberger@forba.com

A Great Way To End The Week