Is Private Equity Contributing to Dental Abuse? Federal and state regulators are looking into whether dentistry companies backed by private equity are being encouraged to perform unnecessary procedures, Bloomberg News reports
Bloomberg News on Dental Management Corporations: Patient Abuse, Private-Equity Funds & Medicaid Fraud - Wall Street Money Fuels Coalition Against SB655 in North Carolina
Protect the public. That’s the deceptively simple mission of any American dental board. But while the mandate may be uncomplicated, its execution is anything but. Critics of board actions say they range from misguided and contradictory to baldly self-interested. Controversial decisions are increasingly putting boards under fire. Among the more common sources of complaint are unfair and unequal treatment of dentists; failure to quickly address malpractice and the unlawful restraint of competition.
Perhaps nowhere is the board under greater fire than in Texas, where the executive director recently resigned. Sherri Meek’s abrupt exit followed a rocky stint punctuated by frequent dispute. In particular Meek was assailed for allowing board members to act as paid expert witnesses in lawsuits against Texas dentists; the practice posed a clear conflict of interest. Long-time opponent Dr. Mark Stankewitz, a prosthodonist, used YouTube to decry the Texas board as “a good- ole-boys’ network…some dentists receive slaps on the wrists for serious matters and others serious consequences for much less significant offenses.”
Dentist-turned-attorney Frank Recker used the same language—a good-ole-boy’s network—to describe his own experience on the Ohio State Dental Board in the early 1980s.
State dental board officials will come to town in early June to investigate long-simmering allegations that a Bakersfield dentist mistreated children while they were strapped to a papoose, or stabilizing board, several local parents say.
Many of the parents involved also allege excessive, unnecessary or flawed dental treatments from Dr. Edward Dove.
"I struggle with the fact that it's taken a long time, but at least movement is coming quickly now," said parent Chris Cook, who has led a grassroots mobilization effort. "I'm exhausted but that doesn't mean I stop -- he ain't getting away from me."
Dove did not respond to an interview request, though he said last year that he gives excellent care, has never hurt a patient and the parents are "making it up." Dove, who has a clean disciplinary record, also said last year that the papoose board was necessary to keep some of his young patients immobile during treatment.
Since the parents banded together with a Facebook page last summer, the Bakersfield Police Department has conducted "a couple of investigations" into Dove's care, said Sgt. Joe Grubbs. He said police have been unable to substantiate any criminal wrongdoing, and are not actively investigating Dove now.
News of the Dental Board of Californiavisit follows the decision by a high-profile Colorado attorney not to take the local parents' case.
Jim Moriarty, who is currently representing a young patient in a case of alleged pediatric dental abuse that's received national lawmaker attention, said the Bakersfield case involved too few local parents, a weak expert on his side, and too much "he said/she said." He also said being an out-of-state attorney was challenging.
Despite that setback, which parent Cook called "extremely shocking," the parents' case is still building momentum. Along with the coming dental board visit, they've collected about 1,000 signatures for an online petition to revoke Dove's license. Several weeks ago, Cook's son was featured with other Bakersfield children in an Inside Edition television segment, which investigated dental papoose boards.
To papoose or not?
Papoose boards, many of which have Velcro straps, are used to hold young patients in a stable position while procedures can be safely done.
Many of the parents' complaints against Dove stem from the slaps and scratches that reportedly happened while their children were restrained on the board, under partial sedation. Parents weren't allowed in the room during the process, something Dove has said is important since they can interrupt and distract from care.
The American Dental Association responded to that Inside Edition show with a press release detailing guidelines on when such stabilization should be used.
The American Academy of Pediatric Dentistry says papoose boards might be used when young patients require immediate diagnosis but can't cooperate due to "a lack of maturity or mental or physical disability;" when the safety of the patient, dental staff or parents would be at risk; or when movement of sedated patients needs to be reduced.
In general, papoose boards aren't considered part of routine dental care, said Dr. Paul Casamassimo, a pediatric expert at the Nationwide Children's Hospital in Ohio and a past president of the American Academy of Pediatric Dentistry. For a typical, healthy child, it would not be the first course of action.
[Dr. Casamassimo has failed to mention since 2008 he has been on the the board of advisors to one of those Private Equity dental chains-Small Smiles. I would like to ask Dr. Paul Casamassimo why he’s done nothing to stop the use of the papooose board, mainly used to expedite treatment, in the Small Smiles Dental Centers. In fact Dr. Casamassimo and Dr. Steven Adair, Small Smiles new Director of Clinical Quality Initiatives and Education and asshole buddies as they say, putting on a CE course together in Adair’s home town of Hilton Head, North Carolina.]
"Most people undergoing procedures in a dental office can stand still," he said. "It would be a hysterical child, or one who is too young to understand what is going on who would need the papoose."
At Ohio State University, a resident in one of Casamassimo's programs is working on a thesis project looking at parental attitudes toward papoose boards as well as other techniques like oral sedation, anesthesia and distraction/positive reinforcement.
Thirty years ago, parents would have said they'd rather have their children held down and the job done, Casamassimo said. Now, though, he has seen a 180-degree shift, as parents prefer putting children to sleep for extensive care.
[Is it the parents, Dr. Casamassimo or is it your pocketbook that prefers sedation. I call BS on that 30 years ago crap, 30 years ago no one had ever heard of such a thing. Were you papoosed Dr. C?]
In a previous interview, Dove pointed out that using general anesthesia is much costlier than using the papoose board, which can be a factor for parents struggling financially.
Another shift in dental practices is the increasing movement toward having parents present during care, Casamassimo said. He said the group of dentists who preferred that parents stay out of the room is largely retiring and a new generation wants the family more involved.
[Increased shift toward parents being present?? Would that be because of this blog and the lashing you’ve taken for the past four years. If not for the force of the Federal Government, Small Smiles would still be keeping parents in the waiting rooms.
[I want to know when the shirt was away from having parents present? Actually, that was something Dr. Casamassimo and some of his colleagues hatched to not let parents know what they were doing to the children back in those rooms. Dr. C is as much a part of this problem as anyone. He’s held various offices at the AAPD for decades!]
Regardless of whether parents are in a room, they should actively understand the extent of the procedures, the pros and cons, and be comfortable with it, he said.
That's not what Bakersfield parent Kristy Andreas says she experienced when she took her then-3-year-old son, Evan, to see Dove. If she had understood Evan would be papoosed, she would have insisted on staying with him, or at least behind the door, she said.
Evan says he was scolded and hit during his dental procedures, Andreas said. In addition, Andreas found Dove's care faulty. She ended up getting not just a second but a third opinion to prove it, all of which she said she has documented in her dental board complaint.
Attorney setback
Late last year, Colorado attorney Moriarty told The Californian he was poised to represent Bakersfield parents and was planning a visit here to ink the deal. Earlier this year, he said he was having an expert review some of the children's dental records.But last week, he said he had decided not to take the case.
Moriarty's other dental clients have been in the headlines recently for a case against a dental management company. Such management companies, which are often backed by private-equity money, are the subject of a U.S. Senate inquiry.
Moriarty said some private-equity backed dental businesses routinely bilk Medicaid patients, mistreating them in the process. Even though Medicaid reimbursements tend to be very low, the idea is that the businesses can make money if they practice "assembly line medicine."
"They routinely papoose and grossly sedate children, routinely refusing to allow parents to be present," he said. "They do that to keep parents from knowing what they're doing."
Moriarty said he was drawn to the Bakersfield case because of the parents' mobilization efforts. Ultimately, though, there was too much "he said/she said" and it would have required working with another California-licensed attorney since he was out of state, he said. Besides, he specializes in going up against private equity-funded dental businesses. Dove owns his own business.
Moriarty was clear that he still supports the California parents' mission.
"What Chris Cook and the other families did -- banding together, raising hell and bringing attention to the authorities --brings to light" conduct which otherwise would not be brought to life, he said.
That's exactly what local parents hope to accomplish June 9, when they say dental board investigators will interview their children at the Bakersfield Police Department.
If a dental board investigation finds a preponderance of evidence some violation has occurred, the next step is for the case to go before an administrative law judge, said Russ Heimerich, a spokesman for the dental board. He would not comment on any specific details of the Dove case.
But that could take some time. From January to March of this year alone, the dental board received 969 complaints. From the intake of a complaint to disciplinary action -- if it is deemed necessary -- takes about 1,100 days on average.
"I know some people want it wrapped up in an hour, like CSI," Heimerich said. "But these aren't investigations that happen overnight."
Staff writer Jason Kotowski contributed to this report.
Bloomberg has published an article today that you just have to read.
It starts with a mom in Arizona picking up her (sobbing) 4 year old after school, only to learn that a dentist had installed steel crowns on two of his back teeth — "pulpotomies" according to a note in his backpack. Baby root canals.
The mother hadn't even been consulted. "I was absolutely horrified," she said.
No, this wasn't Marathon Man for toddlers. So why this aggressive act of dentistry?
It was about money. Profits. Private equity. And a new plague known as "dental abuse."
Bloomberg explains:
Isaac’s dentist was dispatched to his school by ReachOut Healthcare America, a dental management services company that’s in the portfolio of Morgan Stanley Private Equity, operates in 22 states and has dealt with 1.5 million patients. Management companies are at the center of a US Senate inquiry, and audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry.
ReachOut, Bloomberg reports, is one of just 25 dental management services "bought or backed by private-equity firms in the last decade." The management services take care of the business side, leaving the dentists to focus on teeth. The trouble started when the profit-driven businesses began seeing opportunity in your tax dollars: Medicaid.
Maybe that's why there's a big cavity in the US government's budget?
A former physician once counseled me that dentists were "a bunch of crooks, out to get rich." At the time, I took that with a grain of salt. Thanks to Bloomberg, I won't even floss without exercising caution.
AsBloomberg reported today, Private Equity is seen as the driving force behind abusive dentistry and Medicaid fraud. Little Isaac Gagnon, is still suffering from night terror from the abuse he endured while he was supposed to be safe at school.
However, it is “We The People” who are picking up the tab and enriching Private Equity firms coffers into the billions of dollars. But that is not the biggest price being paid.
The biggest price of all is the dental health of each and every American!
This is not a Medicaid patient only problem. The same driving force is behind places like Heartland, MidWest, Pacific Dental, BrightNow, Aspen Dental, Affordable Dentures, Comfort Dental and now Wal-Mart is getting in on the action. The list goes on.
Some private equity firms have figured ways to overcharge Medicaid for dental work, and Texas seems to be a hotbed. The Texas State Board of Dental Examiners is investigating dozens of cases where dentists billed Medicaid for unneeded work or for services they didn't do. A Dallas orthodontist who reviewed Medicaid dental claims for the state told Congress that fraud in Texas is flagrant and that some dental clinics engaged in the illegal practice of dentistry.
Don't credit the state for uncovering the scandal. A series of exposes by Byron Harris of WFAA revealed little oversight of the state Medicaid program. He reported that more than 20,000 Texas children under age 12 received braces in a year's time. One clinic billed Texas Medicaid more than the whole state of Illinois spent on Medicaid dental care.
Chew on that a while if you wonder whether Texas state government is keeping a close watch on spending your tax dollars.
Read more here: http://blogs.star-telegram.com/investigations/2012/05/speaking-of-texas-teeth-combine-devious-dentists-with-dubious-private-equity-firms-and-what-do-you-get-soaked-taxpayers-ac.html#storylink=cpy
Special needs child taken from class and received root canals, stainless steel crowns and excessive X-rays without parents consent or knowledge, while his brother was next to him hearing his screams of pain and fear.
Dr. Alvin Coon working for ReachOut Healthcare America's Big Smile mobile dental program deliver the horrifying treatment and could be headed to jail. Just two weeks ago a child in California had 4 teeth pulled while at school by the same company. The company is under investigation in AZ and CA.
Rumor has it, Dr. Andrew Loomis – date of hire May 23, 2011- is purchasing the Small Smiles Dental Clinic in Pueblo, Colorado and the current employees last day is late next week.
Anyone besides me crying foul and not believing that an actual sale is happening?
I find it odd that a guy who has been with the company for less than a year is purchasing the original Small Smiles. You know the DeRose family is not going to allow anyone to control their original clinic. I’m sure it hold a massive amount of sentimental value.
The clinic just so happens to be housed in a building owned by the DeRose-Padula Enterprises. This sounds like North Carolina and DeRose’s fake sale of the Smile Starters Dental Centers to his employee, Raf Rivera, DDS about the time he agreed to pay $10 mil to settle fraud charges.
If I were a dentist purchasing the clinic, where I had been an employee for a year. There was a full staff with whom I had worked all during that time, I would most likely keep them on, wouldn’t you? Why wouldn’t you? Some of those let go will be bound by non-compete agreements won’t they?
I’m pretty darn sure Michael DeRose, Eddie too, are on the List of Excluded Individuals and Entities and are not to participate in the Medicaid program, directly or indirectly. I guess DeRose Padula Enterprises is not on that list so it can participate? All sounds ridiculous doesn’t it? That’s because it is ridiculous.
Presumably Randall Ellis, DDS owns the place, right? He is one of those “fake” owners for Church Street Health Management. One thing is for sure, if Randy Ellis, DDS actually owns the clinic,as he has filed sworn documents attesting to, then he should have some serious capital gains on that 2012 tax return on his.
However, if you go back and look at the entity documents on file with the Colorado Secretary of State’s website, I’m not sure it ever left the DeRose Family in the first place.
All Personal Property is billed to Church Street Health Management, LLC in Nashville, assessed at $34,996.
Land and Building belongs to DeRose Padula Enterprises. Assessed value for 2012 is $430,411. (land 77,500 structure $352,911)
So what did Dr. Loomis purchase and from whom did he purchase it? Has this been reported to the Bankruptcy Trustee?
How many papoose boards did he get in the deal? I notice they are not actually listed as being part of Church Street Health Management’s assets, but surely they are part of the $34,996 of “personal property”. Did he get his contract back so he’s not auctioned off like a slave in a human trafficking ring?
May 1, 2012 -- Carlos Armin Morales-Ryan, DDS, 45, and his wife, orthodontist Nelia Patricia Garcia-Morales, DDS, 42, of Laredo, TX, have pleaded guilty to making false statements on bills to Texas Medicaid.
Drs. Morales-Ryan and Garcia-Morales owned and operated Orthogenesis International Centre, a dentistry and orthodontics business, and a substantial portion of their business was targeted toward Medicaid-eligible children.
Medicaid regulations required them to be in their offices when services are provided to Medicaid patients.
Dr. Morales-Ryan has admitted that though he and his wife were in Hawaii on or about October 12, 2007, he falsely represented to Medicaid that he performed an evaluation and management of a new patient on that date. Dr. Garcia-Morales has also admitted she falsely represented to Medicaid that she performed an orthodontic retention on March 23, 2007 when she and her husband were en route to the U.S. from the Virgin Islands.
As a result of their plea agreements, they will be sentenced to five years' probation and will pay $686,545 to the Texas Health and Human Services Commission-Office of Inspector General.
Dr. Morales-Ryan currently is not licensed to practice dentistry in Texas due to another unrelated criminal proceeding.
This letter was received last week from a Small Smiles employee. It is one of two received last week alone. Hopefully any identifying info was scrubbed, if not, oops, sorry.
My job is obviously a nightmare. I have been an employee with the company since March. A lot of funny business goes on. We are a profitable clinic probably when I first started in we were averaging 100 patients a day which is close to $10,000 a day now we see approx. 50.
I for the last year have been miserable at my job but as a single mom with no child support I struggle to leave and possibly lose my apartment, etc.
It's not so much that i think what we do at my office in unethical most times I do agree on the treatment. Big changes in the last year obviously after the Medicaid fraud we have a million compliance meetings, the state cracked down on reimbursement for stainless steel crowns. We no longer papoose (for the most part) as I was seeing many in a day we may have one a month..everyone's scared.
[well at least I’ve accomplished something!]
They are acting as if we will stay open and tell us very little. Always constant changes weekly at small smiles..such as bill out what was before a periapical as an occlusal etc...no more papooses for Dr's etc.
[ so was it fraudulent billing before or now?]
All I really know is when they filed they told all 67 clinics over the phone a big 67 clinic phone conference and we were encouraged to ask questions basically it was that Tori guy who said business as usual...they don't want the company morale to be down so they don't tell us any new news.
Steve Adair told the Dental hygienist's if they see an HIV patient to double glove spray the room and leave it for two hours..who says this???? Exactly the opposite of what I learned in school.
Anyway the anxiety level I have when I get to work and the fear the boss puts in you and the company morale is terrible. They have us going out now doing ten minute marketing in which I have to walk the streets and pass out toothbrushes to passerby's encouraging them to come to Small Smiles.
Well in a city it’s the same damn people everyday. My bosses are acting like nothing is happening but a few of us follow your blog closely. It's the only truth we get. Dr (intentionally removed) is the current lead dentist "owner "of the office I work at, he is (age removed) spinning in circles and about to have a heart attack. I actually feel for this guy he is so going to get thrown under the bus. He does whatever they say no matter what he thinks
[ He is exactly right. He will be, the whole business is designed to protect the quarterback; Corporate Headquarters.]
But it's his own fault I said to him, “you actually own this place and he said no, I paid $100 and they put my name on the building. I think what he said is BS.
I was venting sorry so basically I was wondering if no one bids on this hellhole by the 11th this Friday could it be the doors are locked Monday?????????? or probably not going to happen until after the 22nd...??????????
Can they possibly prolong the agony and then file chapter 7? I wish I could quit and go collect unemployment and state how horrible stressful and much anxiety this job gives me but I know they would fight it and I would lose and then put my daughter and I in a poor situation...
I wish there was something I can do..we started seeing adults in November 2011. I think they got a huge tax break for that or maybe are just desperate for any patients we can get.
I feel terrible telling these adults go see the oral surgeon get your teeth extracted then come back and we will fit you for dentures and I have no idea if we will be here???? Any thoughts, any advice????
I thank you for your blog..it's my only knowledge and when they told us in a morning huddle that Lori Steiner-chief compliance officer was going back to her roots and leaving CSHM. I was silently cracking up thinking about your blog which usually is the topic of our lunch room conversation and her last day (Lori Steiner the compliance officer) is May 31st how convenient.
Another dentist concerned about or lead/owner told me privately that she spoke with our lead/owner, and told him he should get a lawyer since he's the owner. He told her he had corporate lawyers.
The dentist looks at me and laughs and says “he's going to fry....”
[yes he is! so things must still be a bit shady around there, maybe?]
I feel that those of us who read your blog know more than they do. I just wonder if no one buys CHSM are we definitely closing??? Could they possibly only close some clinics and keep some open??? We have had a few people leave and they are not replacing them. But they tell us they aren’t replacing them because we have slowed down...everything is a lie.
I’d love to say thanks again for sharing your story Debbie...I just want it to end for me the girls I work with and the patients.
This one blows my mind. This was an ad that landed in many dentists email box on Monday. 1-800-Dentist selling "leads" for prospective new patients on "state aid". Now, I ask you, what medical provider is patient shopping for potential patients in a program most all says reimburses way too little? Only a big dental mill would be willing to pay $25 per lead for 'state aid' patients.
Is 1-800-Dentist selling patient contact information or are they a third party broker and selling the names of patients which would be (assets) of bankrupt dental clinics such as Small Smiles and All Smiles? Someone needs to be asking?
HIPPA violations?? Anyone?? Bueller?
Where did 1-800-Dentist get these names? At the Corporate Dentistry Going Out of Business Sale?
What's really fantastic, is they can sell the same stuff over and over and over and over again. This is really not unlike the paid patient hunters where dental clinics have employees hit the food banks and food stamp office and get paid per head to bring them directly to the dental office. The patients want to come to get their wal-mart gift cards and such! Win win!
CHESAPEAKE, Va. (WAVY) - A trip to the dentist can evoke pain, anxiety or fear. Those feelings generally subside once your appointment is over. But for one Chesapeake family the pain will never end. It's been five years since their traumatic visit.
Today, they want to challenge parents; they want them to question their child's dentist.
On March 9, 2007, the Blanco family took their 8-year-old daughter Raven in for a simple procedure. She would be sedated, worked on, then awakened from her sleep.
But Raven never woke up.
Raven's father, Mario Blanco, often visits Norfolk's Forest Lawn Cemetery; that's where Raven is buried. He brings a chair and sits a few steps from her headstone. It's time alone with his eldest daughter. He opens up to her.
"I don't hear her talk back, but I feel her presence," Mario said.
There is a picture of her at the burial site and Mario meditates on her sweet smile. The same smile still fills the Blanco's Chesapeake home. There are family pictures in every room.
Raven's mother, Robin Blanco, still finds her young daughter's death hard to accept.
"For me, the longer the time goes by, you learn to cope with it. But the longer the time goes by, I miss her more," Robin said, her voice cracking.
Raven was sedated for a routine dental procedure. While getting the work done, complications arose and her heart stopped. Robin watched as staff members performed CPR on her little girl. Crews rushed the child from the dental office to the hospital emergency room.
"I remember a doctor coming out and telling... you know, that they've done all that they can do," Robin continued tearfully. "And did I want to see her - you know I just couldn't believe it. And I said, 'Yes I want to see her. I want to see her.' I just couldn't believe it. And she was gone."
In Raven’s memory, the family started The Raven Maria Blanco Foundation, Inc.They follow and share the stories of other children who’ve died following complications at the dentist.
By their count, 11 have lost their lives in the past year.
Today they're on a mission to educate parents and they want dentists to be prepared. Raven's cousin, Nicole Cunha, is spearheading those efforts.
"People have to go to the dentist, people have to have these things done, there are children with anxiety that have to be sedated, they have to have the work done on them, so no you can't take that away, you have to know what to do if something goes wrong," Cunha said.
Virginia Beach Oral Surgeon Dr. Scott Goodoveputs into practice what Raven’s foundation wants in every dental office. He told us, "If we have an emergency, our assistants are prepared. They have stations to take if we have an emergency from the back to the front."
Each morning he holds a staff meeting and goes through the patient list. They discuss any medical complications that could arise.
Dr. Goodove sedates hundreds of patients each year. That's far more than a general dentist. But he points out that oral surgeons also undergo years of specialty training. His advice for any dental office, whether they sedate or not, be ready for a worst-case scenario.
"What we have here is sort of a more organized central emergency station.... (Our) patients walk in, they feel comfortable, 'Hey ... these guys are prepared.'"
In a corner of his office he has an automated external defibrillator (AED), a tank of oxygen, a range of medications and drugs. There's also an emergency response guide.
"It's as simple as picking the emergency - someone passes out - and it will give you the step-by-step guide. But you don't want someone reading this for the first time during the emergency itself, so you run through these drills."
And Dr. Goodove holds mock drills every month. For general dentists, not doing deep sedation procedures Virginia dental regulations don’t go nearly that far. That’s where the Blanco’s want the public to help.
"If we get a group of the whole country coming together, and demanding these things, you'll see a big change," Mario said. Mario eventually wants to see these preparedness practices become law - Raven’s law - as he sees it.
Meantime, much of his time is spent sitting across from Raven burial site, as they keep each other company. Her epitaph reads: "'The most beautiful girl in the world a beloved daughter and sister who is missed and loved so much. One day we will all be together again....' And we will."
Click here to watchthe portion of our interview in which the Blanco's discuss taking their other children to the dentist for the first time, following Raven's death.
Hello, After going to the link that showed all the children that had lost their lives due to "complications" at the dental office, I felt like I just needed to tell someone briefly what I have experienced as someone "in the field". I live in Va. Beach and was a dental assistant for almost thirteen years. (I left the field in 2004 after working in an adult practice, and since that time I actually work in the cemetery industry as a General Manager at a cemetery in Va. Beach) I worked five of my thirteen years in a pediatric office. (Drs Sundin and Bullock) and about two months after that at Drs Hechtkopf and Cox. (1998) I did not work long at the last office because the unsafe practices that they undertook actually scared me.
When a child had to have a lengthy procedure they were given Chloral Hydrate for the procedure as well as Nitrous Oxide. (and Lidocaine of course) The dental assistant would come out to the waiting room and get their patient and bring them back. Then the assistant would mix the Chloral Hydrate based on the dose prescribed by the Dr. and give it to the child. Within about ten minutes the children would literally just start getting drowsy and then basically pass out. We would then have to hold them until it was time for them to have their work done...if the office was busy that day then sometimes that could be up to 45 minutes. During that time (and this happened A LOT) the children would begin vomiting...while unconscious and we would have to try to hold them upright while this was happening.
When the procedure would start, the child (who was already completely unconscious) was given Nitrous. It was jacked up way over the necessary level (about 70%) and to the point that it would induce nausea and vomiting even in an adult...but especially on a child that was already sedated. While the child was being worked on (with the papoose board) they had a heart monitor on...when their heartbeat would start to increase the Dr. would say, "Okay...get ready...here we go!" (Because the heart rate would increase when they were getting ready to vomit.) They would not reduce the Nitrous strength and we would just have to keep suctioning as they were getting sick.
After the procedure was finished, they would turn on the straight oxygen and start to try to wake the child up. They would still be very groggy when we would carry them back out to their parents, however we were not allowed to tell them that their little child had just spent the last two hours vomiting while unconscious. We did give them precautions for them to eat lightly and to watch them while their mouth was still numb so that they wouldn't bite the inside of their mouth, etc. They never had any idea what had happened back in the office though. That is the part that was so upsetting to me.
I happened to be CPR certified, however this was not a requirement for the job. I was never asked before I was hired if I was. That I know of, none of the assistants were ever shown emergency procedures. I know I was not. This happened on an almost every day basis. Now, when I started the job, I did have eight years of experience and five of those had been in a pediatric office...however the requirements to get a job in Dr. Hechtkopf and Cox's office were very minimal.
I am saddened to hear these stories...I can very easily see how these tragedies could take place. The dentist most of the time very heavily relied on their assistant to have already checked the child's health history without every looking at it themselves. (This was the story in every office I worked at unfortunately.) I'm truly sorry that this happened and I hope that you sharing these stories will help to regulate the requirements of dentists and their assistants in the future. I just felt like I needed to tell what it was like behind the scenes because I can easily see how this could have happened. Sincerely, Kim
David Culver of WAVY 10 TV reports on the deadly dangers at the dentist office. Full piece to air on Monday, May 14, 2012 starting at 5:00 PM. Please watch and share.
On May 5, 2012 Kevin Rector of the Baltimore Sun devoted 1042 words to an article questioning the mental and emotional health of Jenny Olenick who died April 6, 2011during a sedation procedure to extract 4 3rd molars (wisdom teeth). Jenny was 17 years old. One has to wonder who actually wanted that many words devoted to this case, it certainly wasn’t Jenny’s mom, Cathy Garger. I doubt the writer was actually monitoring the civil case in the courts, so who handed over this piece to Rector? I doubt it was an idea from the bankrupt media conglomerate Tribune newspapers, which is the Chicago Tribune, Los Angeles Times, WGN TV and others. Whoever it was, should have thought more about it and made another choice. Below is the link to the article.
My heart goes out to the family of Jenny Olenick, who by all accounts was a talented and wonderful teen. The May 5 article detailing events surrounding the filing of a malpractice suit, "Lawyers question teen's health before death," got my attention for several reasons.
To imply that pre-exiting conditions, such as stress, anxiety and heart disease would have contributed to or caused her death seem far-fetched. As reported in the article the autopsy report found "no evidence of a physical process, like cardiomyopathy having occurred," according to the state's chief medical examiner. Regarding the premise of "undisclosed medical conditions," the article states that Ms. Olenick had a medical evaluation and was "cleared" for anesthesia and surgery.
Katy Stech May 11, 2012 (c) 2012 Dow Jones & Company, Inc.
A federal court watchdog wants to put a hold on the $25 million sale of the operator of Small Smiles Dental Centers to a private equity firm--a deal that a bankruptcy judge has yet to approve--until the Tennessee-based chain sheds light on its post-closing moves.
U.S. Trustee Samuel Crocker, who monitors bankruptcy court pleadings for the Department of Justice, wants company executives to be clearer about the financial professional who would take over the bankruptcy estate once distressed investor Garrison Investment Group purchases its operations on May 31, according to papers filed in U.S. Bankruptcy Court in Nashville, Tenn.
I heard the the infamous Doug Brown and Kirk Huntsman might be involved before it ends. if so, Doug Brown would be involved in more Private Equity “Medicaid dental mills” and “pull every tooth in your mouth and slap in some cheap denture” operations in the world.
Upon the motion of The Official Committee of Unsecured Creditors, by and through counsel, it is ORDERED that individuals designated by Fireman’s Fund Insurance Company shall appear for examination pursuant to Fed. R. Bankr. P. 2004 on May 16, 2012 at 9:00 a.m. C.S.T. at the offices of Baker,Donelson, Bearman, Caldwell & Berkowitz, P.C., 211 Commerce Street, Suite 800,Nashville, Tennessee 37201.
IT IS FURTHER ORDERED that individuals designated by Fireman’s Fund Insurance Company shall produce the documents as specified inExhibit 1 to the Committee’s counsel at the above address not later than May 15, 2012 at 4:00 p.m. C.S.T.
IT IS FURTHER ORDERED that the attorney for the movant shall serve a copy of this order on the party or counsel for the party required to appear and to the U.S. Trustee.
The attendance of an entity for examination and the production of documentary evidence are compelled in the manner provided in Fed. R. Bankr. Proc. 9016 for the attendance of witnesses at a hearing or trial. Dated: May 4, 2012
Who wants to bet they do all they can to postpone this one?!! LOL
Exhibit A of Exhibit 1 – List of Small Smiles Dentist Names I’d bet a whole crap load of these 916 dentists are on Santa’s Naughty list. No wonder I was told some of the folks in the below list are spinning in their shoes and support employees are afraid some are going to have a heart attack.
“Dr. Weber violated the trust of his patients, by hiding the true nature of his relationship with the credit financing companies, and through the substandard care he provided,” said Eric T. Kanefsky, Acting Director of the State Division of Consumer Affairs. “Egregious violations such as these cannot, and will not, be tolerated by our licensing boards.”
A Nigerian man who lied to become a U.S. citizen has been sentenced to three years in federal prison for immigration fraud and Medicare fraud.
Plano resident Okey Nwagbara, 45, is the first person to be imprisoned for crimes connected to Medistat Group Associates -- the DeSoto business run by Dr. Jacques Roy (right), who federal prosecutors say orchestrated a record-setting home health-care fraud scheme.
Nwagbara, who owned a company in Richardson called Advanced MedEquip and Supplies, cut a deal under which prosecutors recommended letting him serve his sentences for both crimes simultaneously. U.S. District Judge Sam Lindsay agreed to this in assessing punishment Monday.
The defendant had asked for an even more lenient sentence. Prosecutors objected last month, calling Nwagbara "a fraudster of the highest order" whose immigration fraud "merely laid the groundwork for his next fraud scheme: accessing Medicare and stealing as much as he could without getting caught."
"Upon receiving cash payments from Nwagbara, Bullard would sign 'JRoy MD' on Medistat prescription pads, durable medical equipment information forms (DIFs) and 'Certificate of Medical Necessity' for enteral nutrition products falsely indicating among other things that the beneficiary required tube feeding," according to a summary of facts signed by Bullard. He has also pleaded guilty to Medicare fraud and faces sentencing June 4.
This morning at 9:00 a hearing was to be held in Nashville Bankruptcy court whereby Church Street Health Management, LLC was asking the court to modify the final Debtors In Possession (DIP) Order and to reschedule the closing of the sale of Church Street Health Management ,LLC to CSHM, LLC. They want to set it for May 31, 2012 instead of May 30, 2012 and they want to remove a legal service agreement with King and Spalding. (lol…they are gonna miss that income!)
Church Street Health Management , LLC and CSHM, LLC are two completely different companies now, so keep that in mind from this point forward. Church Street Health Management, EEHC, LLC, FORBA NY, LLC and Small Smiles Holdings, LLC are now combined into one company, namely CSHM, LLC. At least that is what it will become when the sale closes with Garrision
In their “Assumption Notice” (Doc 301, 302, and 302 Schedule A) is listed all the contract and obligations the new buyer will assume and have possession of at closing of this Rule 363 sale. The first one filed May 1, 2012 had 14 pages of those phony Management Service Agreements with phony clinic owners and employment agreement contracts, intellectual property such as trademarks, non-compete contracts with the original founders-The DeRose-Padula family- and other miscellaneous agreement, contracts and business agreement. A new and amended Schedule A was filed the next day, May 2, 2012. Yes, there was a change, a tiny one; King and Spalding were removed as having a Legal Service Agreement with the new CSHM, LLC.
From reading the “Assumption Notice” , the new new CSHM, LLC will only “assume” a little over $700k ($707,399) (see assumptions and "cure" amounts here)of Church Street Health Management, LLC, EEHC, LLC, FORBA, NY, LLC and Small Smiles Holdings, LLC $23,607,147.40 of debt. (According to Form 1 Schedule F here-Doc 213, starting on page 51)
Suspiciously missing from the debt the new buyer would now assume is $4,911,378 listed as still being owed to several states on a March 23, 2012 report. (Here on page 51)
BTW, who were those $10,000 loans made to that were listed on the March 2012 expense report?! Who loans money when they are broke? (see here on page 6)
Didn’t they report in February they recovered $4 billion in fraud in 2011. That’s $4 billion that escaped from the hands of CMS, right?
FOR IMMEDIATE RELEASE Thursday, May 10, 2012
HHS finalizes new rules to cut regulations for hospitals and health care providers, saving more than $5 billion Changes will reduce costs and allow more focus on medical care
[Reduce costs for whom? I’ve heard this for years now, and my costs keep going up, how about yours?]
Today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced significant steps to reduce unnecessary, obsolete, or burdensome regulations on American hospitals and health care providers. These steps will help achieve the key goal of President Obama’s regulatory reform initiative to reduce unnecessary burdens on business and save nearly $1.1 billion across the health care system in the first year and more than $5 billion over five years.
“We are cutting red tape and improving health care for all Americans,” said Secretary Sebelius. “Now it will be easier for health care providers to do their jobs and deliver quality care.”
The new rules are being issued today by the Centers for Medicare & Medicaid Services (CMS). The first rule revises the Medicare Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs). CMS estimates that annual savings to hospitals and CAHs will be approximately $940 million per year.
The second, the Medicare Regulatory Reform rule, will produce savings of $200 million in the first year by promoting efficiency. This rule eliminates duplicative, overlapping, and outdated regulatory requirements for health care providers.
“These changes cut burdensome red tape for hospitals and providers and give them the flexibility they need to improve patient care while lowering costs,” said CMS Acting Administrator Marilyn Tavenner. “These final rules incorporate input from hospitals, other health care providers, accreditation organizations, patient advocates, professional organizations, members of Congress, and a host of others who are working to improve patient care.”
Among other changes, the final rules will:
Increase flexibility for hospitals by allowing one governing body to oversee multiple hospitals in a single health system;
Let CAHs partner with other providers so they can be more efficient and ensure the safe and timely delivery of care to their patients;
Require that all eligible candidates, including advanced practice registered nurses and physician assistants, be reviewed by medical staff for potential appointment to the hospital medical staff and then be granted all of the privileges, rights, and responsibilities accorded to appointed medical staff members; and
Eliminate obsolete regulations, including outmoded infection control instructions for ambulatory surgical centers; outdated Medicaid qualification standards for physical and occupational therapists; and duplicative requirements for governing bodies of organ procurement organizations.
Have these folks not been paying attention to Church Street Health Mangement-Arcapita-CIT-American Capital-Small Smiles deal? What about Valor Investment Partners, and Richard Malouf in Texas?!!
In coming days they will swear up and down they don’t own anything, they just give our money to folks who say have Management Service Agreements with clinics. AUA Private Equity and Topspin Parnters, you better have attorney’s look over this more carefully.
Hint: Don’t use Waller Lansden… Not until you need a sweet deal the the DOJ, then they are your guys. Just saying… Todd and Scott, this is to you, take the money and run..fast as you can! I bet I know what you did, but do they? AUA Private Equity Partners LLC, New York-based private equity firm, introduced the Topspin team to the deal and co-invested. The owner-operators of the company, brothers Todd and Scott Singer, retained large equity stakes in the company.
From the folks at PE Hub: Topspin Partners LBO, a lower mid-market buyout shop, has made a substantial investment in Brighter Dental Care, a chain of dental practices in New Jersey, Buyouts reported earlier, citing firm Managing Director Leigh Randall .
The company’s seven practices perform general dental, periodontic, orthodontic, endodontic and oral surgery procedures, and employs a business model in which the patient spends more time with the dentist early on than is customary at a typical practice in order to plan long-term care, Randall said. The company’s enterprise value is between $10 million and $50 million, he said.
“It’s very much a ‘Let’s see what the state of your oral is,’” Randall said. “It’s not just about a getting a dental cleaning.”
Roslyn Heights, N.Y.-based Topspin typically invests $5 million to $10 million of equity in its deals, and is about 60 percent invested in its debut buyout fund, a $132 million vehicle it raised in 2007.
AUA Private Equity Partners LLC, another New York-based private equity firm, introduced the Topspin team to the deal and co-invested. The owner-operators of the company, brothers Todd and Scott Singer, retained large equity stakes in the company.
Beyond the company’s business model, Topspin was drawn to some trends favoring the dental practice industry. Estimated expenditures for dental care grew at a compound annual rate of approximately 7 percent from 1998 to 2008, and are expected to grow at a rate of approximately 6 percent over the following decade and reach $180 billion by 2019, according to the Centers for Medicare & Medicaid Services.
A Loomis State Enforcement Chief was part of a recent investigation into a Sacramento dentist whose license was suspend recently for allegedly performing procedures people didn't need on healthy teeth.
Local officials in the dental field say there are steps consumers can take to protect themselves from being victims of dental fraud.
Loomis resident Kim Trefry, enforcement chief for the Dental Board of California, said the agency received reports that Dr. David Lewis was performing thousands of dollars of complex work on patients that didn't need it.
In October he was served with a search warrant and evidence was collected from his office. Files revealed that many of his targeted patients were UPS employees because their plan covers 100 percent of dental work, with no co-pay and no cap, she said.
"We received information that he basically was doing work on sound and healthy teeth to create what would appear to be cavities in the mouth and then billing an insurance company to make repairs he had just created," Trefry said.
An insurance company and former employee alerted the board she said. In 2006, he billed an insurance company $150,000, only to bill them $829,000 in 2010 for many procedures people did not need, she said.
Trefry said while this type of fraud is not common and Lewis has closed his practice and been placed on suspension until his hearing, there are things local patients can do to prevent this from happening to them.
Aside from ensuring a dentist has a current license and no record discipline against them, patients should ask questions she said. "If something doesn't sound right, you ask questions; get a second opinion," Trefry said.
She said depending on the dental school someone went to they may have different opinions about how to treat something, but patients should always know what they are seeking out of any treatment they undergo.
She also advises consumers to be aware of what their insurance plan covers and what they may have to pay for out of pocket. For Auburn-area residents who may have been patients of Lewis, Trefry said they could take action in a civil case or file a complaint with the board. So many complaints have already been filed she said it may not change the outcome of the case at this point.
Cathy Murchison, dental administrator for Chapa-De Indian Health Program in Auburn, Woodland and Grass Valley, said she would start by talking to friends and family for reputable dentist recommendations and discuss each procedure before it is completed.
"That they involve you in the decision, explain it to you so you understand and also offer you options," Murchison said. "Not only just options, but the pros and the cons to either doing it or not doing it, so you are prepared." Murchison said their may be some cases where patients would do well to get a second opinion.
"If they are going to diagnose anything that is very expensive, it is always good to get a second opinion," Murchison said. "At least that would put your mind at ease if two doctors recommend the same treatment."
If same holds true for All Smiles in Texas, Michal DeRose and family of Small Smiles along with Richard Malouf and cast of All Smiles, are laughing all the way to the bank and the Private Equity firms who were mislead by counsel are crying in their beer.
Has anyone wondered who Valor Investment’s front man dentist happens to be, since Malouf no longer owned more than 50% of the centers, Valor needed a pretend owner to be on the various PLLC documents.
The “pretend” owner is Dr. Adrian Martin Codel, of Chicago, Illinois, Valor’s headquarters.
Adrian Martin Codel All Smiles Dental – Texas AC Dental – Chicago
Dr. Adrian Codel
After graduating from Northwestern University Dental School's last graduating class in 2001, I went on to complete a General Practice Residency at the Illinois Masonic Medical Center.
This hospital based dental experience included training in IV sedation and Special Needs patient care in a clinical and O.R. setting. The public health component involved providing dental care on a mobile dental unit.
I enjoyed this aspect of dentistry so much, I stayed on as an attending dentist primarily on the mobile unit. Specifically, providing free urgent care to the homeless Chicago population Friday nights. In addition, I was an associate dentist for a pediatric dentist my first 3 years after receiving my GPR certificate.
In 2005, I purchased an existing dental practice and have been a solo practitioner in this urban community based practice since then.
In October 2010, I was approached by a colleague interested in making an equity investment in the largest provider of dentistry in the state of Texas. I agreed to consult him in this purchase and am currently the president/owner of All Smiles Dental Centers which oversees 38 clinics and 5 mobile units providing dental care to the undeserved population in Dallas and surrounding areas. http://www.sharecare.com/user/dr-adrian-codel/bio
Now, unless Dr. Adrian Martin Codel is a complete imbecile, he knew he was breaking all kinds of Dental Practice Acts by doing this. I’ll give him kudos though; he at least admits he was approached to help with an “Equity Investment”.
I think he might have been approached before October 2010, his Texas dental license was issued in September 2010.
Now he’s linked up with the most outrageous, flamboyant criminal dental enterprise since Michael A., Eddie and Dan DeRose and their FORBA a/k/a Small Smiles.
Hmm…All Smiles, Small Smiles, …. I’m thinking a nice jingle is in order!
Dr. Adrian M. Codel Illinois Lic info: Number-019025709 Status-Active Date Issued-10/29/2001
Texas Lic info: Number – 0025986 All Smiles Dental Ctr –Abrams 6780 Abrams Rd. #207 Dallas, Texas 75231 312-217-9630Status - Active Date Issued –09-14-2010 Disciplinary Actions- No Permits – Nitrous-issued 10-12-2010
Yay! A District Attorney with some kahuna’s. Looks like the Office Manager is gonna get nailed too. Unless she’s wise and rolls over on Dr .Kalili. But as we have seen, some will go down with the ship. Sad, really sad.
A Beverly Hills dentist accused of insurance fraud was arrested Friday in connection with a criminal complaint charging him with 101 felony counts, the District Attorney's Office said.
Tom K. Kalili, 57, is scheduled to be arraigned early next week on charges including insurance fraud, grand theft of personal property and filing a false tax return.
Kalili owns and operates Beverly Hills Medical Suites, a dental office located at 416 N. Bedford Drive, according to the District Attorney's Office.
KTLA reported that Kalili and his partners have celebrity clients who include Jim Carrey, Kathy Ireland, Adam Sandler, Keanu Reeves and Vin Diesel.
Kalili's office manager and biller, Claudia Ventura, 38, is charged with 10 felony counts, including insurance fraud and accessory after the fact. She is set to be arraigned next week along with Kalili.
The charges stem from a multi-year investigation by the California Department of Insurance, the California Dental Board and the California Franchise Board.
Prosecutors were asking that Kalili's bail be set at $500,000 and that Ventura's bail be set at $25,000.
If convicted as charged, Kalili could face more than 50 years in state prison and Ventura could face more than seven years behind bars, according to the District Attorney's Office.
This should make every man, woman and child world wide, mad as hell. There should be crowds of people in front of the “gansta's house along side the news trucks.
Richard J. Malouf, just gave the, Department of Justice, the US Attorney’s Office, the citizens of Texas as well as every prosecutor in Texas the finger. But not the one he is using in the picture to the left.
On March 21, 2012 the US Attorney’s office in Texas allowed Richard Malouf to say he would pay them $1.2 million dollars to walk away from fraud charges he committed between 2004 and 2007.
All Smiles Dental Centers various Names, members, executives and agents.
All Smiles Dental Centers, Inc All Smiles Dental Centers All Smiles Dental and Orthodontics All Smiles Dental, PA All Smiles Dental Professionals* Arlington Smiles by Wire, PLLC AS Property Holdings, LLC* Dallas Smiles, PLLC** Discount Dental Services Fort Worth Smiles by Wire, PLLC* Fulton Road Smiles, PLLC** Garland Road Smiles, PLLC8*,** Garland Road Smiles by Wire, PLLC**
*Officer, Member, Director or Agent: Richard Malouf,DDS 9090 Skillman St. Ste, 200C Dallas, TX 75243
Haltom City Smiles, PLLC*,** Jacksboro Smiles, PLLC*,** Jacksboro Smiles by Wire, PLLC*,**, *** Lewisville Smiles, PLLC*,** Northwest Highway Smiles, PLLC*,** NW Hwy Smiles by Wire, PLLC Oak Cliff Smiles, PLLC Park Plaza Smiles, PLLC*,** Plano Minyards Smiles, PLLC*,** S. Hampton Smiles, PLLC*,** St. Francis Smiles, PLLC*,** Valley View Smiles, PLLC
I bet Church Street is happy All Smiles filed and got my focus off of their big month of May. Sorry to disappoint. I’m still focused, as I have been for 4 plus years. CSHM simply should not have tied down and abused children to steal tax dollars.
They simply can’t stay afloat if they are under the watchful eye of a Corporate Integrity Agreement. Which translates into, they can have no integrity and must rely on fraud.
Looks like Richard Malouf,DDS is trying to claim he’s a creditor. That’s because he didn’t take the lump sum option when he sold out to private equity. ROTFLMAO!
Some of these suppliers are gonna be next.... i.e. Henry Schein. They seem to make every list. When you lay with dogs, you're gonna get fleas!
All I’m saying, is if I were a company like Henry Schein, I would be demanding accounts to be paid in full by close of business tomorrow! Extend NO more credit. This is the real dental crisis! Currently I wouldn’t touch this stock with a ten foot pole!
Oh, and one last piece of advice, I’ve said on here before but I will say it again. DO NOT TAKE THE PAYMENT METHOD WHEN YOU SELL TO CRIMINALS. Contrary to popular belief, there is NO honor among thieves. A con artist made that up!
It appears some is preparing for something, not sure what, a book, a movie, a fiasco. Church Street Health Management's PR firm, Rubin Meyers registered the domain drillingfordollars.com. It was registered on April 19, 2012.
If the company isn’t willing to “comply” it doesn’t matter how many “compliance officers” you hire.
Who would want to go to work for a company:
1. on the chopping block 2. has been in serious financial difficulty for 3 or more years! 3. blows through compliance officers like kids thru bubble gum 4. who has failed to even want to comply with the Corporate Integrity Agreement they are under. (see the Auditors Report for 2009 and 2010 in the below Sales Agreement link.
Church Street Health Management LLC (CSHM) is one of the largest (bankrupt)dental practice management companies in the nation, and focuses exclusively on supporting dental centers caring for pediatric Medicaid beneficiaries and their families. CSHM seeks an SVP, Chief Compliance Officer, who will be based in the company’s Nashville office (that we owe a ton of back rent to) and responsible for overseeing the compliance efforts of the company nationwide (that we have no intention of following”. Reporting to the CEO, (who we aren’t clear will be) the selected individual will be responsible for implementing and maintaining policies, procedures and practices designed to ensure compliance with the requirements of all Federal health care programs as well as its Corporate Integrity Agreement with the Department of Health and Human Services’ Office of Inspector General. (that up to this point we’ve basically disregarded because we can’t make moola if we comply)This position is a high profile (it will be when you are jailed) and fast paced (looking for places to hide) position with visibility (too visible) to Executive management, the Board of Directors and (very) significant governmental constituents. Attention to detail, organization skills, ability to see the big picture and accuracy are critically important skill sets.
The Tennessean reported: A Nashville-based company that manages dental care centers in 22 states has filed for bankruptcy to restructure its debt and eventually attempt to sell its operations and assets.
Church Street Health Management LLC’s filing with the Middle Tennessee U.S. Bankruptcy Court this week listed roughly $85 million of assets and $300 million of liabilities.
How much goodwill did it take to get Church Street's sheet to balance? Owners not only stretched the value of the company, they took liberties with kid's teeth and billing Uncle Sam.
That debt includes $150 million owed to its lenders and $17 million owed to several states and the U.S. Department of Justice under a settlement of charges that it billed Medicaid for unnecessary dental procedures for low-income children.
The settlement period runs from September 2006 to January 2010, all years under PEU ownership. Church Street's sins include:
(1) causing claims to be submitted by the Centers for reimbursement for performing pulpotomies that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care
(2) causing claims to be submitted by the Centers for reimbursement for placing crowns that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care
(3) causing claims to be submitted by the Centers for reimbursement for the administration of anesthesia (including, without limitation,nitrous oxide) that was not medically necessary, that was performed in a manner that did not meet professionally-recognized standards of care, and/or was administered by an unlicensed, non-certified, or otherwise unauthorized individual
(4) causing claims to be submitted by the Centers for reimbursement for extractions that were not medically necessary and/or were performed in a manner that did not meet professionally recognized standards of care
(5) causing the Centers to fail to obtain informed consent for certain dental procedures and services
(6) causing claims to be submitted by the Centers for reimbursement for fillings that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care
(7) causing claims to be submitted by the Centers for reimbursement for sealants that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care
(8)causing claims to be submitted by the Centers for reimbursement for radiographs (i.e., x-rays) that were not medically necessary, were taken in a manner that did not meet professionally recognized standards of care, and/or were taken by an unlicensed, non-certified, or otherwise unauthorized individual
(9) causing claims to be submitted by the Centers for reimbursement for behavior management techniques, including without limitation those techniques involving a papoose board, that were not medically necessary and/or were performed in a manner that did not meet professionally-recognized standards of care.
The above behavior resulted in a $24 million (plus interest) fine. It seems Carlyle and Church Street are morally bankrupt as well as literally.
Did Church Street pay dividends or special distributions since The Carlyle Group invested in the company in September 2006?
If so, did PEU owners load Church Street with debt to fund payouts?
Medicaid considers management fees and capital cost reimbursable items on the acute side of health care. Does it do the same for dental?
How much did Carlyle, American Capital Strategies and Arcapita pull out of Church Street before it imploded?
[A LOT!]
Did any buy credit default swaps on Church's debt? That could help ease the ache, but it would continue the morally bankrupt theme.
Private equity purports to be the savior of America's lopsided health care system. Greed won't help, not in the least.
Arcapita(f/d/b/a First Islamic Bank), another principal part of the terrorizing company, also filed bankruptcy.
Below are Statements and Reports of Church Street Health Management – Small Smiles filed with the Bankruptcy Court. You don’t want to miss these.
After graduating from Northwestern University Dental School's last graduating class in 2001, I went on to complete a General Practice Residency at the Illinois Masonic Medical Center. 
This should make every man, woman and child world wide, mad as hell. There should be crowds of people in front of the “gansta's house along side the news trucks. 