Are High-Volume Dental Chains Exploiting Kids on Medicaid?

by Olga Pierce ProPublica, Oct. 2, 2012, 2:27 p.m.by Charles Ornstein and Lena Groeger, ProPublicaby Dan Nguyen, Charles Ornstein and Tracy Weber, ProPublicaby Robin Fields, Al Shaw and Jennifer LaFleur, ProPublica

David Heath of the Center for Public Integrity recently investigated a new breed of corporate dental care chains that cater to low-income adults and children. Heath collaborated with Jill Rosenbaum of PBS FRONTLINE on "Dollars and Dentists." They found a high-volume business model that scored dentists on production and offered bonuses based on the revenue they brought in. Heath and Rosenbaum reported that Georgia-based Kool Smiles, the biggest Medicaid dental provider, has been accused by state regulators of giving shoddy or unnecessary care to some of America's poorest kids. (Kool Smiles' response is here.)

As part of our ongoing look at patient safety, we occasionally interview other journalists who've examined health care quality.

PP: What did you find in your reporting? Heath: I looked at what impact corporate dentistry is having on the care being provided. We looked at two of the larger chains, and found evidence that these companies were putting pressure on their dentists to produce at certain revenue targets, thus encouraging them to do procedures that may have been unnecessary.

PP: Can you say a bit more about the harm or overtreatment to patients that you saw? Heath: One of the chains focused on kids on Medicaid, and the reimbursement rates for Medicaid are pretty low. So in order to get a lot of revenue from these patients they were doing things like taking x-rays that were not needed, or putting stainless steel crowns instead of fillings on their teeth. They could make twice as much money from Medicaid on these crowns versus just putting a filling on a tooth. Kids were getting treatments that they really didn't need. We also looked at a chain that focuses on adults who haven't been to the dentist in years.  What were found there is again, patients would come in and everyone was given the same treatments. They were given these deep cleanings and a lot of people would get dentures and we were finding that in some cases maybe they didn't need those services. We had one example of an 87-year-old woman who had already been to the dentist and she went in to have two teeth pulled, thinking it would be cheaper at [New York-based] Aspen Dental. Instead they looked at her mouth and they came up with a treatment plan that was going to cost $8,000. They convinced her though hard-sell tactics to borrow that money through a credit card, and something like $2,000 of that was just to clean her teeth. (Aspen Dental's response is here.)

PP: So, in some cases, you're talking about pulling someone's teeth unnecessarily? Heath: There was a case where a woman went in who needed to have some teeth pulled, but they pulled all of her upper teeth, and several dentists told us she didn't need that.

 PP: What are the market forces that have resulted in private equity-owned chains providing dentistry? Heath: These days, when dentists get out of dental school, they often owe anywhere between $200,000 and $300,000 dollars. Dental school is actually more expensive than medical school. So they come out with these huge debts, in a lot of cases they can't really afford to start their own practice. These dental chains hire people, a lot of the time right out of dental school, and they pay fairly decent salaries and they have a bonus system where the more work you do on a patient the more you get paid. That's true for a private dentist as well, but the difference is that these companies are owned by private equity firms, and they're managed in a different way. You have people who are not dentists coming up with a business plan that's based on metrics. They try to get new patients in who haven't been to the dentist in a while, and they've already calculated how much revenue the average new patient should generate. If you happen to go in and you don't really have anything wrong with your mouth and you're a new patient you're not fitting the model. That creates pressure for the dentists to find things that are ‘wrong.'

 PP: Is dentistry particularly ripe for these kinds of abuses? Heath: In dentistry there's not really any peer review or oversight. So there's really not anyone to challenge dentists. And patients almost never challenge that kind of thing either. For somebody who's not ethical, there's a lot you can do and get away with in dentistry.

 PP: How is it that so many kids in Medicaid have ended up relying on corporate chains for their dental care? Heath: Not that many dentists actually accept Medicaid. There are some states where the reimbursement rates are so low that even the chains don't go there. Like in Florida, for example, the Medicaid rates are so low there that chains don't really even bother. So children end up going to the emergency room because they have a toothache and there's nothing else they can do. They end up in hospitals to treat a tooth. There was a famous case in Maryland where a 10-year-old boy had a toothache and it was abscessed and he ended up dying because he didn't have a dentist. [Note: According to a recent study, only about a third of children in Medicaid-- which covers more than 30 million American children -- will see a dentist in a given year. In Florida, where reimbursements are particularly low, only a quarter of the children in Medicaid see a dentist.] In other states, like Connecticut, Texas and Virginia, they have dramatically increased reimbursement rates. You have more options there, but not the same options a someone who can afford it. Dentistry is a little unusual from doctors because a lot of people don't have dental insurance, and even if you do have dental insurance it often doesn't cover a lot, and a lot of dentists don't take insurance any more because of low reimbursement rates. So even if you have dental insurance, finding a dentist can be a challenge. So there is a real problem, especially for children, to find a dentist if they don't have money.

PP: Are changes under way as a result of your story? Are there solutions on the table? Heath: There is a [U.S.] Senate investigation still ongoing, I don't know what will come of that. There are investigations in some of the states, Texas being one, looking at this issue. I think there are things in the works we really won't really know the full impact of for a while yet. We definitely got the attention of the dental community; we got a lot of feedback from them. This whole issue of accepting patients who have limited resources is a real issue in dentistry and something I think the dental community has to sort out.

Dr. James Fruehan - “token” arrested dentist for October 2, 2012 ?

 

October 2, 2012

Wayne County, PA dentist charged with Medicaid Fraud

HARRISBURG - A Wayne County dentist was arrested today on charges that he fraudulently billed the Medical Assistance program for more than $75,000 worth of patient procedures that were allegedly not properly performed or not administered.

Attorney General Linda Kelly identified the defendant as James Fruehan, 52, 51 Marshwood Bend, Clarks Summit. Fruehan is a licensed dentist and owns and operates Fruehan Family Dentistry, 15 Fruehan Drive, State Route 590, Hamlin, Wayne County.

According to the criminal complaint, Fruehan submitted claims to Medical Assistance for sealants and prophylaxes (teeth cleanings) that were not provided by Fruehan or licensed dental professionals.

The charges state that Fruehan allowed dental assistants, who did not have a a proper license, to perform teeth cleanings on patients. Fruehan allegedly billed Medical Assistance more than $31,000 for prophylaxes that were provided by the dental assistants. 

Kelly said that more than $35,000 worth of fraudulent claims were allegedly submitted for dental assistants writing "sealants" in the patients? charts, which indicates that they were not done by a dentist, dental hygienist, or expanded function dental assistant.

Teeth Whitening Booth at Oklahoma State Fair Closed By Dental Board

There is no doubt – I’m an idiot. One with a “God Complex”, I’m told. I know this to be true, since I don’t understand the difference between shutting down a teeth whitening booth at the county fair and shutting down illegally operating dental clinics. Here, the Oklahoma dental board actually “staked” out the place and words like “felony” were used.

TULSA, Oklahoma -

Posted: Oct 02, 2012 5:01 PM CDT Updated: Oct 02, 2012 5:39 PM CDT

Lori Fullbright, News On 6

The State Board of Dentistry shuts down a teeth whitening booth at the Tulsa state fair. The Board got an injunction against EuroShine USA for practicing dentistry without a license.

The Board got a complaint, then staked out the booth Monday and watched them treat six people. The Board says there was a lack of knowledge and sanitary cleanliness that put people's health at risk.

On Monday, the Dentistry Board told the booth workers to stop operating, then went back the next day with the court order.

Read the application for temporary restraining order

Read the temporary restraining order

When the booth opened Tuesday, the employee began taking down the signs advertising teeth whitening for $40. The Dental Board says the blue light they saw the employee using isn't supposed to be used on people with cataracts or who've had cataract surgery, yet no medical histories were taken.

Nothing out of DC, or anywhere else, on Organized Criminal Dentistry - Why? When?

It's October 2, 2012. Organized criminal dentistry continues with as much vigor today as in 2007. Still, only silence out of Washington.

On November 4 it will be 5 years since the public saw the first video of what these Medicaid dental mills were doing to children. It's been 5 years since I learned of this abuse and I'm still fighting mad over it. It shakes me to my core to think what would be happening if i weren't. As a select few of other Americans, I devote every day to squashing this, dead in its tracks. Does anyone, besides these few  give a shit care?

How many times in the last five years have we heard the cry of corporations at the feet of Congress pleading for more money, citing the death of one child over a tooth infection that migrated to his brain – Deamonte Driver? Too many! This poor child’s death is being used, by corporations and associations, as a tool to abuse other children and be paid by the taxpayer to do so.

How many times have we heard the cry of corporations at the feet of Congress over the abuse of Miguel, seen in the exclusive video? None! N.O.N.E! None! Has any company, or association for that matter, been to Congress pleading for someone to stop the practice of children being tied up in straight jackets, held by 3 or 4 misguided dental assistants only to receive what can only be called barbaric dental treatment? No!

It was 2003 - 9 YEARS ago - when a young reporter – Stuart Watson- in North Carolina first reported about the DeRose family's child abuse for tax dollars scheme. Most enduringly referred to as - "serving the underserved."

It's 2012. The abuse continues daily. The only real thing to change is one, the companies playing the game, more folks want in on the action. Two, the changed the terms used to describe the crimes. “Quota” was changed to “Goals”, the “Goals” changed to “Targets” and “Targets” to “Forecasts”. It’s hard to find new words for abuse a child for a dollar, though.

There are mounds of evidence detailing this criminal behavior which has landed on the desks (or trash cans) of Attorney Generals, Senators and Congressmen - both Federal and State levels. More than enough to make sweeping arrests and stop this child abuse and raping of every taxpayer this very day. Yet, another day will pass and no one stops it. No one closes the doors of the dungeons or arrests the dungeon masters.

You've seen what these children are subjected to - the videos, the testimony, the documents, the first hand accounts from employees, patients and parents!

You've seen testimony of a small child being "waterboarded" by Small Smiles corporate dentist - Megann Scott. Yet, only a "waterboarded" terrorist gets your attention!

You've been shown, just recently, that children are literally kidnapped at bus stops, taken thru the back doors of clinics, then coerced into forging their parents signature! Yet, you do nothing!

You've allowed the chop shops to set up in every poor neighborhood in the country. Even given them our tax dollars to do so.  If allowing these predators this much access to our babies and children was not enough, you've allowed them access to children in our public schools, via gypsy style mobile dental clinics. You have been shown the devastation children are enduring because of this practice - Isaac Gagnon.

You've seen the deaths of babies sedated for over-treatment of dental procedures, yet, you do nothing!

It is a disgrace, crime against humanity, and a black mark on the entire county, to continue to allow this to happen another day. In my opinion, a much bigger than the Fast and Furious debacle.

It's worse than disgraceful this is still happening, 5 years after first being alerted to these children being abused. I am saddened at what is becoming the biggest disgrace of all - the lack of action!

I'm embarrassed nothing is being done - other than a few token arrests of a dentist here and there. Only one, that I'm aware of from the criminal organizations themselves - dentist and inventor Robin Lockwood in Oklahoma.

The companies who have perfected this madness don't even try to defend their actions any longer. Kool Smiles - NCDR for example. The best they can do at this point combat their disgusting behavior is to hire someone that in essence said, "we can abuse and mangle more children for less" My GOD! Are we all insane?!

Are lawmakers and law enforcement hoping the pool of patients will just run dry if it's ignored long enough? I'm note sure. They wouldn't have to bite the hands that feed their campaign coffers, would they? These abused children are growing up, they have not and will not forget the horrors bestowed upon them by these brutal dentists. Nor, will they forget those who sat idly by and let, if not encouraged, it to happen. I doubt they will subject their own children to these abuses, though it may mean no dental care at all for future generations. (This could explain why there is always a crisis in dental health here in America.)

This very day – Tuesday, October 2, 2012- thousands more children will be abused in these clinics, it will happen again tomorrow. What will it take to stop this? Tell me, please. What do you need?

Millions of tax dollars dollars will be paid to companies today to physically abuse, mangle children faces and mouths and leave crippling emotional scars. One such child who suffered these horrors well over a year ago, just this past weekend, gained the courage to leave her mom and spend a few short hours with her grandparents! How is doing nothing about this, OK?

This week, I’m spending my time nurturing a grandchild or two or three. We will be decorating pumpkins, and doing anything else I can think of to give them loving memories. Hopefully they will carry these moments in their hearts and minds, long after I’m gone.

Prosecutors, Attorney Generals, everyone on Capitol Hill, this is to you:

Will you stop the barbaric child abuse and torture by greedy dentists today?

Will you please end this nightmarish treatment that is emotionally crippling our most vulnerable – our children, our grandchildren?

The millions of children who have been permanently scared by abusive dentistry can’t enjoy “Kodak moments”, as above. Their  minds, emotions, as well as their mouths are forever damaged. We as parents and grandparents can’t give them enough loving memories to erase these horrors from their minds.

Do something today?

Erie PA dentist pleads guilty to fraud–Dr. Kristi Ayn Liebau-Grassi

Former Erie-area dentist pleads guilty to billing fraud

By ED PALATTELLA, Erie Times-News
ed.palattella@timesnews.com

Friday September 26, 2012 11:32 PM

Former Erie-area dentist Kristi Ayn Liebau-Grassi would have gone up against many of her former patients if she had gone to trial on fraud charges.

The patients or their parents were prepared to testify that Liebau-Grassi billed Medicaid for dental work -- including crowns and the equivalent of root canals for children -- that was unnecessary or never provided.

The courtroom confrontations will not occur.

Liebau-Grassi, 39, pleaded guilty in U.S. District Court in Erie on Wednesday to 14 felony counts that she defrauded Medicaid by making false statements in health-care matters. The government said the fraud occurred from January 2008 through March 2011, when she was practicing at 4010 East Lake Road in Lawrence Park Township and at the UPMC Hamot Surgery Center.

Liebau-Grassi agreed to pay restitution of $289,000 and faces a year to 18 months in federal prison at her sentencing before U.S. District Judge Sean J. McLaughlin on Feb. 13.

Assistant U.S. Attorney Marshall Piccinini and Liebau-Grassi's lawyer, David Ridge, agreed that the federal sentencing guidelines call for that amount of time for Liebau-Grassi, who has no prior record and who will get credit for pleading guilty.

Liebau-Grassi formerly lived in the 6000 block of Bridlewood Drive, in Fairview Township, and now lives in Sugar Land, Texas, near Houston. She remains a licensed dentist, according to the Pennsylvania Department of State. She is free on her own recognizance.

The U.S. Attorney's Office charged Liebau-Grassi, also identified in court records as Kristi Ayn Liebau, by filing what is called a criminal information against her in August. The federal government typically secures grand jury indictments, but Liebau-Grassi, signaling her desire to end the case quickly, agreed to waive an indictment and plead guilty to the information.

Liebau-Grassi spoke softly and dabbed her eyes with a tissue as she told McLaughlin she wanted to plead guilty.

The FBI and a Medicaid investigator with the state Attorney General's Office built the case against Liebau-Grassi. They opened the probe to review concerns about the dental work she said she provided to patients, most of whom were children, Piccinini said.

The investigators found Liebau-Grassi performed unnecessary work, performed work and then billed it as more expensive work, billed for work on teeth that did not exist and billed for procedures so numerous she could have not performed them in the allotted time, Piccinini said. He said patients and other dentists were prepared to testify against her.

In one case, Piccinini said, Liebau-Grassi billed for performing 16 pulpotomies -- or root canals for children -- and installing 16 steel crowns and four composite fillings, all in 17 minutes of surgery time.

Ridge, Liebau-Grassi's lawyer, has said she pleaded guilty to take responsibility for "any and all billing problems."

Liebau-Grassi on Wednesday admitted she was the sole person who signed the billing forms for her office.

ED PALATTELLA can be reached at 870-1813 or by e-mail. Follow him on Twitter at twitter.com/ETNpalattella.

Senator calls for dental inspections Peeler says he'll introduce legislation if need be

Written by
Tim Smith, Staff writer

COLUMBIA — Routine state inspections now protect people more from bad food at restaurants than from possible unsafe conditions in dental offices, says the chairman of the Senate Medical Affairs Committee, who said he wants the state to begin routine dental inspections.

And the chairman of the Senate Judiciary Committee told GreenvilleOnline.com that he thinks the Legislature should look at the idea of routine inspections and broaden them to medical offices.

Sen. Harvey Peeler of Gaffney, who heads the Medical Affairs Committee and is the Senate’s majority leader, said he previously wasn’t aware that dental inspections weren’t conducted by the state.

The Greenville News and GreenvilleOnline.com revealed this month there were no inspections — unlike at least 15 other states — though the state does regularly inspect barber shops and hair salons and looks into complaints about dentists or dental offices.

“If need be, I’ll sponsor the legislation,” he said. “If you inspect a restaurant that you are putting food in your mouth, it seems like you would inspect a dentist office where you put a hand and instruments in your mouth.”

Sen. Larry Martin of Pickens, chairman of the Senate Judiciary Committee, said lawmakers should at least study the idea of routine inspections.

“I think that’s something we ought to look at since that issue has been raised,” he said.

Martin said one reason the state may not have developed a system for inspecting dental offices is that three agencies have some part in regulating them — the Department of Health and Environmental Control, the Department of Labor, Licensing and Regulation, which houses the state dental board, and the state Occupational Safety and Health Administration.

“That may be why there’s no systematic inspection, no more so than there would be of a doctor’s office,” he said.

Martin said other than responding to certain complaints, state agencies might not regularly look at dental and doctors’ offices, even though the labor agency does systematic inspections of manufacturers or other businesses under OSHA responsibility.

“Maybe there should be,” he said. “I don’t know why they wouldn’t ensure that those various requirements are being met on a spot-check basis.”

Asked how Gov. Nikki Haley felt about requiring routine inspections, Rob Godfrey, her spokesman, said the idea has been discussed by the state Dental Board.

“LLR licenses the professional, not the facility, as is authorized by statute, and LLR does undertake inspections when it receives complaints about licensees — the Dental Board by comparison to other boards receives a relatively low volume of complaints,” he said. “The Dental Board has discussed legislation to mandate inspections but thus far none has been introduced.”

“It doesn’t matter a whole lot to me one way or the other,” said Sen. Ray Cleary, the only dentist on Peeler’s committee. “If they think they need more of them (inspections), my feeling is we need to give government the tools they need to govern. So I don’t have a problem increasing the budget for that.”

Cleary, who said he has been in practice since 1975, says he has a “fairly upscale practice.”

“So my patients expect that,” he said. “I haven’t been in some offices that are not upscale, so it’s hard for me to relate to it.”

At least 15 states, according to the American Association of Dental Boards, conduct routine inspections. Nine more — including South Carolina — conduct inspections only if a consumer complaint is lodged.

Other states’ inspections have found violations.

Already this month, six dentists in Ohio, plus a radiographer and a registered dental hygienist have been cited by the Ohio State Dental Board for infractions and violations of that state’s laws and safety precautions, according to public records. Those citations were due to routine inspections conducted by that state’s Dental Board.

The routine inspections in Ohio, said Lili Reitz, executive director of that state’s dental board, are to prevent slips or lapses — or even outdated methods — from occurring. She prefers not to think dentists would deliberately break safety guidelines, even though she knows that happens.

“We’ve had everything from dentists bringing pets into the office to them sterilizing instruments in toaster ovens,” she said. “We have a checklist for them to follow. A dentist can’t say they’re caught off-guard.

“But in 90 percent of the cases, we’ll find a violation or two. When we do, we’ll be back.”

Recently, her inspectors visited a Veterans Administration hospital after a consumer complaint. VA facilities don’t usually fall under the board’s jurisdiction, but they conducted an emergency inspection regardless.

“We discovered a dentist had potentially infected 600 patients with Hepatitis C because he wasn’t sterilizing properly,” she said. “He wasn’t using gloves, he wasn’t meeting standards. He was 81 years old and that’s how he’d always done it.

“How would you ever know this if you’re not going out there to inspect?”

The South Carolina Board of Dentistry conducts licensing exams and annual registration of dentists, dental hygienists, dental laboratory technicians and ortho-technicians.

It also investigates complaints and conducts disciplinary hearings. But it doesn’t conduct routine inspections. Nor does the state Department of Health and Environmental Control, which treats dental offices differently than some other medical providers, such as hospitals or nursing homes.

Under the South Carolina Occupational Safety and Health Administration, dentist offices are subject to federal safety standards like the “Bloodborne Pathogens Standard” and guidelines for X-ray machines. Employees must safeguard themselves with gloves, face and eye protection and gowns, but no routine inspections are conducted for compliance.

This leaves the state’s dentists solely responsible for infection control in their own facilities, responsible for patient safety, for their own safety and for the safety of their staff.

An examination of the latest LLR annual report, from 2010-11, shows the state has 2,700 dentists, 3,300 hygienists and 3,600 dental assistants. Those individuals were subject to 86 complaints during the fiscal year. Those complaints prompted 71 investigations. From those, two licensees — not necessarily dentists — were ordered to cease and desist; one entered into a consent agreement; and nine received letters of caution.

Employee complaint about dental office sanitation

http://news.com.au/national/dentist-clinic-operates-without-steriliser/story-fndo4ckr-1226483364907

Judge stops case where dentist sues patient for Yelp review

http://www.kval.com/news/local/Dentist-who-sued-patient-over-Yelp--171840671.html?m=y&smobile=y

Whistleblowers, we should all be one!

Whistleblowers Help Texas In Medicaid Fraud Cases

• by Becca Aaronson
• September 27, 2012

With the help of private whistleblowers, Texas has reaped more in Medicaid fraud settlements with pharmaceutical companies than any other state, according to a report released Thursday by Public Citizen, a nonpartisan consumer advocacy organization. 

“When I’ve spoken with a couple of other states, they definitely recognize Texas as a leader in enforcing pharmaceutical fraud,” said Dr. Sammy Almashat, one of the report's authors.

Texas has recovered at least $354 million in Medicaid fraud settlements from pharmaceutical companies since 1991 with the help of private whistleblowers, according to the report. Almashat said that’s because under Texas law, whistleblowers can receive between 15 to 25 percent of the financial penalties of a Medicaid fraud settlement for bringing the case forward.

Although 13 states have similar laws, “Texas is a unique case, because other states haven’t been nearly as active as Texas in taking advantage of whistleblower revelations in prosecuting,” civil Medicaid fraud, said Almashat.

“A whistleblower brings unique underlying knowledge about the fraud that was perpetrated by the defendant in the case,” said Daniel Hodge, first assistant attorney general. In all civil Medicaid fraud cases — including those against pharmaceutical companies and many others — in the last 10 years, Texas has recovered $880 million, said Hodge, and $373 million of that went to the state treasury. 

The whistleblower cases are entirely responsible for that $880 million, Hodge said, explaining that although the Inspector General at the Texas Health and Human Services Commission referred 12,000 criminal Medicaid fraud cases to the AG's office since 2002, during that same time, that agency only referred three civil Medicaid fraud cases.

Currently, a top priority at the AG’s Office is to pursue orthodontic and dental fraud in the Medicaid Program, said Hodge. The office has assembled the Orthodontic and Dental Fraud Task Force to combine resources at various agencies, including the Office of Inspector General at the HHSC. At least one case being pursued by the task force was referred by a whistleblower. 

Given the significant portion of the state budget that goes to Medicaid, “it’s more critical than ever for the taxpayers that we aggressively pursue any actors that defraud the taxpayers and recover those dollars,” Hodge said. “We’re thrilled that Texas has been recognized for [Attorney] General Abbott’s efforts to prioritize uncovering and recovering waste, fraud and abuse in the Medicaid program.”

Sun Orthodontix raided by FBI–Life in dental fraud is not as rosy as it used to be, is it?

We’re getting there… 

by BYRON HARRIS

Bio | Email

WFAA-TV

Posted on September 26, 2012 at 5:58 PM

Updated today at 6:18 PM

Story TimelineClick to open timeline

Related:

• More from News 8 Investigates

NEWS 8 INVESTIGATES

In the largest action to date, the FBI, state investigators and the attorney general have raided the offices of Sun Orthodontix.

Sun doesn't have locations in North Texas, but it was the second largest biller for braces under Medicaid in 2010.

Part of its huge growth in Texas is linked to Medicaid dental bills. News 8 found Texas dentists were charging taxpayers for putting braces on kids who didn't qualify for them under Medicaid.

Sun collected more than $9.6 million in 2010, according to state records.

FBI agents were part of Monday's raids at Sun offices, which stretch from El Paso to Corpus Christi.

"The FBI doesn't show up when they think you've committed a crime... they know you've committed a crime long before they show up," said Houston attorney Jim Moriarty, who is part of a whistle-blower case against Dallas-based All Smiles Dental Centers.

The joint raid is the largest action so far against a dental firm in Texas.

"I think you may see tens or hundreds of dentists who end up with civil or criminal charges against them," Moriarty said. "I think there is a tsunami of criminal action against crooked orthodontists in Texas."

No criminal charges have been filed against Sun or its dentists. But the company has been in a dispute with Medicaid. The state quit paying Sun Orthodontix earlier this year, questioning its practices.

Sun has taken the state to court for money it says it is owed.

E-mail bharris@wfaa.com

Ohio State Dental Board Compliance Manual

Remember the stories last week about state not inspecting dental offices for sanitation.

Ohio State Dental Board Compliance Manual

Mohamed El Deeb continues to have Minnesota dental license suspended.

Mohamed El Deeb, license number D9508, is no stranger to the Minnesota Dental Board:

November 6, 2008  - Stipulation and Order for Conditional License after a complaint that was serious enough to be referred to the Attorney General. (I guess the Minnesota dental board knows the right person to contact at the AG’s office there, unlike Texas, where they haven’t a clue)

The incident occurred in January 2004. They found “record keeping violations” – a great catchall, like “improper equipment for us motorists” – substandard care and “incorrect billing” – aka “fraud” as it related to three patients. Evidently it related to conscious sedation, as the board called in an expert for a report.

In 2005 there was another complaint. It too was referred to the AG. Somewhere along they reviewed 5 years of his records and found several items worthy of sanctions.

September 24, 2010 Dr. Deeb petition the dental board to have his license reinstated.  They did so, with no conditions attached.

September 7, 2012 – The board issued an order of a Temporary Suspension during a closed session.

September 17, 2012 – The board continued its Temporary Suspension

Don’t’ miss WFAA–TV–Byron Harris Report

I hear there was a raid by the FBI at a Texas Orthodontic clinic. Watch for Byron’s report. 

Think “Sun”shine!

Here’s a challenge -

Here is the Laffer Associates Study that says DSO’s (Kool Smiles, Small Smiles, etc)  perform less procedures per patient than private dentists. It also says they steal less than money per patient than private dentists. Ok, it doesn’t use the word steal…  but still…. 

You can find a link to the raw data at the bottom of page 5 of Laffer’s study. Or at their dropbox here.  Or this dropbox here.

WARNING – if you have a copy saved as an .xls file instead of a .xlxs your speadsheet does NOT contain all the data! 

Here is the challenge – Debunk it!

According to the study they found 35 Texas Providers Identifiers for Kool Smiles in Texas. Considering Small Smiles used at a minimum 25 provider numbers for 4 of their dental centers in 2010, I betting there were a whole lot more than 35  numbers used for Kool Smiles and their many clinics in 2011.  Hell, there are at least 55 “providers” in the Indiana Kool Smiles centers.  It might have been 35 that could be identified, for Texas in 2011, but that’s the point, isn’t it?

Laffer says this about the data:

Data and Methodology
We were provided Medicaid claims paid data for the fiscal year 2011 by Kool Smiles, who had received these data from the Texas Medicaid Program via a Freedom of Information Act request. We did nothing to verify the authenticity or accuracy of these data.
Before going into the results of our analysis, let me provide a few definitions. In Texas, Medicaid covers children in families from no income up to 185% of the federal poverty level for children up to 1 year old, up to 133% of the federal poverty level for children from 1 year old to 5 years old, and up to 100% of the federal poverty level from children 6 years old to 19 years old.

Thus, the data contain all Medicaid claims arising from children aged zero through 19 years, 11 months in families with income up to the applicable multiple of the federal poverty level (the federal poverty level is an annual income of
$18,530 or less for a family of three as of 1/1/12), regardless of what type of dental provider treated the child.

We counted as a procedure every separate dental activity that was charged to Medicaid with a Medicaid billing code.
Unfortunately, the data did not contain a separate total count of patients accessing dental services. Instead, unique patient counts were provided for each Medicaid billing code. To derive an estimate of the total number of patients, we added the number of patients treated via each code for a prophylaxis cleaning and used that count as our number of unique patients.

We used this procedure for all DSOs and all non-DSOs as well.
Prophylaxis cleanings, or “prophies”, are the standard dental cleanings that every patient receives as part of a routine dental visit.24 These dental cleanings, which are typically billed under the same code each visit, provide a more reliable method for this patient count than other routine services, such as exams, which might be billed under different codes and lead to double counting. There are three codes for prophylaxis cleaning, each based on age: D1110 for patients 13 to 20 years old, D1120 for patients 6 months to 12 years old, and D0145, 25 a code specific to the Texas Health Steps program, for children under 3 years old.

The Medicaid data we received contained a count of clients who received the procedure associated with each Medicaid billing code, broken out by location of dental service (see below). Summing the number of clients receiving each prophylaxis procedure thus provides a proxy for the total number of unique patients treated under Medicaid in Texas in 2011.

Accordingly, we use “prophies,” a routine procedure administered with regularity, as the count for unique patients, or “patients,” as we’ll refer to them in this analysis.

Additionally, the data quite naturally did not explicitly identify which dentists were associated with DSOs. The amount of reimbursement doesn’t differ for DSO dentists and non-DSO dentists. In order to receive reimbursements for treatment
performed on Medicaid patients, however, a dentist must apply for and be assigned a Medicaid Texas Provider Identifier (TPI) number. We made a list of all of the DSOs we could identify that do business in Texas, and any TPI that filed a claim using an identified DSO address was counted as being a DSO dentist (see Appendix A for a full listing of all DSOs included in our calculations). All other TPIs were counted as non-DSO dentists. In the process, we dropped the claims data for any TPI that filed with Texas Medicaid but was associated with an address that was not within or immediately bordering Texas.

An important caveat is that the total population of DSOs within the data represents office locations, and not individual dentists. In going through the data, we were unable to find multiple dentists working at the same DSO office billing
separately. With few exceptions for non-DSOs, it seems a rule that most group practitioners bill under a single base (7-digit) TPI instead of their unique and individual 9-digit TPI.

Basically, I read this to say “GIGO” – Garbage In – Garbage Out. So someone spent a hell of a lot of money for a report that means nothing and I mean nothing. Goes to show you though, tell a company what you need it to say, and they can get the data to make it so.

As well, these DSO’s work very hard to hide the fact they are operating as a DSO, since it’s illegal, so the number of non-DSO dentists numbers have to be distorted, right?  Like I said, GIGO!

Civil trial begins for Dr. Brain Seastrunk - accused in child death. Dr. Seastrunk is blaming nurse, Cynthia Jones.

Civil trial begins for doc accused in child death

By Craig Kapitan

Updated 10:57 p.m., Thursday, September 20, 2012

Read more: http://www.mysanantonio.com/news/local_news/article/Civil-trial-begins-for-doc-accused-in-child-death-3882118.php#ixzz27R8SKe00

When 22-month-old Maddoux Cordova woke up from a routine outpatient dental procedure three years ago crying, thrashing and trying to remove his intravenous line, Dr. Brian Seastrunk approved two doses of morphine instead of Advil.

The anesthesiologist's decision, along with his failure to closely monitor the boy after the narcotic was administered, led to the child's death, attorneys for Cordova's parents told a civil court jury Thursday as testimony began in a malpractice trial.

Seastrunk's attorneys have countered that the nurse who requested and administered the drug — and therefore the hospital that hired her — instead is to blame. The hospital also has been sued but is not a party in the trial.

“As a doctor, the rule is you don't expose your patient to needless risk,” plaintiff's attorney Beth Janicek said during an opening statement in 37th state District Court. “That's what they live by. It was needless to order such a powerful drug.”

Cordova was found not breathing by his grandmother the afternoon of Dec. 11, 2009, about five hours after he was discharged from Village Specialty Surgical Center, according to court documents. He was revived by emergency responders but was brain dead, and on the day after Christmas the decision was made to take him off life support.

Gun toting dentist, Dr. Conrad Jim Kusel Jr. uses lethal weapon to keep staff under control during meeting. Lawsuit filed.

All the illegal dentistry happening in Florida, used to stay in Florida. Seldom did news come out about dentists arrests, going mad, or illegal corporate practice of dentistry. But boy, oh, boy, has that changed in the last two weeks!
 
LAWSUIT: Port St. Lucie dentist terrified worker with staff meeting gunplay
 

PORT ST. LUCIE, Fla. -- A lawsuit filed by a former employee claims a Port St. Lucie dentist waved a gun around at a staff meeting, telling staff to "sit down and stay in line."

Everyone agrees the dentist had a gun at work that day.Police reports show six detailed accounts of the same meeting. But the State Attorney's office here never pursued charges against the dentist -- Dr. Conrad Jim Kusel Jr. of the Kusel Dentistry practice in Port St. Lucie.

Lawyers for former receptionist Sunday Sack, a 13-year employee there, say she suffered post-traumatic stress disorder from the February incident in which she and others allege Kusel pulled the gun in an angry tone and said "everyone is going to sit down now and and I'm sure everyone is going to stay in line during the meeting, right?"

Sunday Sack: "That morning that gun was pointed and cocked it, and started to talk, I saw that vein, I saw that vein popping..I literally froze and basically fell down into my chair..I was like paralyzed."

Kusel's brother Brian Kusel is also a dentist there. The suit also names him for not intervening in the situation.

The lawsuit does not specify damages, but Sack says she planned to work there for the rest of her life and is seeking money for lost wages and distress. She's been attending counseling since the incident in February and says she was so affected, she spent months hiding in her own closet fearing for her life.

Sack is now on Social Security disability for her diagnosed trauma. In police reports, Kusel defended his actions by saying the gun was bought with money the staff had given him for the holidays, and he was showing off what he'd purchased. Since the gun-waving incident, three other employees have left the practice.

Imagine if Dr. Thomas Floyd had a gun in his office !!!  He would have shot children instead of jabbing them in the mouth with pliers and beating them in the stomach.

Dr. Tuan Vu – sentenced to 4 years in prison for fraud

Dentist Sentenced for Health Care Fraud

A dentist who lives in Arlington but practices in Alexandria has been sentenced to nearly four years in prison for health care fraud.

According to the U.S. Attorney’s Office, 43-year-old Tuan Vu, who owns Cosmetic & Family Dentistry, PLLC, pled guilty in January to committing health care fraud. Court documents show that Vu admitted the scheme took place at least from January 2007 to September 2011, when he billed dental insurance providers for services he never performed on his patients.

Because of the scheme, more than 50 private insurance providers lost more than $2 million. The federal government and the Commonwealth of Virginia also suffered losses, including more than $300,000 to the Federal Employee Health Benefits Program and the Virginia Medicaid program.

Vu was sentenced to 46 months in prison, to be followed by two years of supervised release. Additionally, he was ordered to pay a $250,000 fine and more than $2 million in restitution.

More on the brutality of Dr. Thomas P. Floyd

This report on Dr. Thomas P. Floyd - West Palm Beach dentist- holds true to the first hand reports I've received. In addition, it was reported to me, that the police received complaints "a couple times a week" about abuse taking place in Dr. Floyd's office. His ex-wife is an orthodontist in the area. Some reports about this brutal dungeon master go back years. To think this man is walking free is infuriating! HE BEAT CHILDREN on a regular basis!!!!!

Thomas P. Floyd, West Palm Beach, Florida Pediatric Dentist, Arrested for Child Abuse

September 20, 2012 , by Elaina Robbins
Thomas P. Floyd, a West Palm Beach, Florida pediatric dentist, was arrested Friday after he was accused of handling one of his 4-year-old patients roughly, reports say. Floyd, 61, was booked into the Palm Beach County Jail on a single charge of child abuse. Officials also suspended his dentistry license following his arrest. It is unclear whether a bail bond was set for the defendant. It is also unknown whether Floyd has retained a private criminal defense lawyer.
Reports say that Floyd operated a pediatric dental office out of the 400 Executive Center in West Palm Beach prior to his arrest. His office specialized in dental care for children, teens, and young adults. However, earlier allegations about malpractice against certain patients reportedly surfaced in 2010. During one of those occasions, a 7-year-old female patient accused Floyd of placing her apron in her mouth during a procedure. The doctor reportedly did this to quiet the patient down. The girl apparently removed the apron, citing that she experienced difficulty breathing with it in her mouth. Reports indicate that Floyd did not face charges regarding this allegation.
In this more recent incident, a 4-year-old patient accused Floyd of striking him in the face several times during his appointment. The patient was not publicly identified by police because he is a juvenile. The case opened after a witness phoned police from Floyd's office, stating that a toddler in one of the office's examination rooms was making distressful noises. When detectives arrived, they located the frazzled boy, who reportedly explained to officers that "the doctor went pow pow on my face, and it hurt."
Investigators found that the child's lip was injured (Floyd purported was a result of the child nipping himself during the exam) and that the child's gums were inflamed. The mother took the child to St. Mary's Medical Center, where doctors located a small laceration under the boy's tongue. He also sustained several cuts to his lips and another cut to his gums. Investigators from the police department and Child Protection services cross examined the child and found the details to his story to be congruent.
A while after the incident, an employee at Floyd's office decided to speak to authorities regarding the boy's treatment. The witness, who remains anonymous, purportedly claimed that Floyd placed the boy on a medical stabilization board, which limited the child's mobility during his examination. He then attempted to perform a dental procedure, but the boy allegedly refused to open his mouth. Floyd then made several alleged attempts to open the mouth with what was described as an irritated mood.
During those purported attempts to open the child mouth, Floyd allegedly pried at the child's jaw with a pair of dental clamps.
However, the child reportedly spit the clamp out and the doctor attempted to force them back in, sources say. When that failed, the assistant alleged that Floyd "jammed" the child's mouth with a dental bit. At one point during the procedure, the assistant claimed that child's mouth began to bleed. The assistant then reportedly asked the patient in the waiting room to call police.

Shawn Zukosk Claims Dental Clinics did Unnecessary Dental Work

Shawn Zukosk Claims Dental Clinics did Unnecessary Dental Work

Submitted by Courthouse News on Sep 21, 2012

SCHENECTADY, N.Y. (CN) - A man claims in court that he was one of many children who received poor dental care at the 22-state "Small Smiles" chain, which federal and state governments accused of doing unnecessary dental work while taking "hundreds of millions of taxpayer dollars."     

Shawn Zukoski seeks punitive damages from Smalls Smiles Dentistry of Albany, five other LLCs or corporations, seven dentists and others.     

The complaint states: "In 2010, top law enforcement officials from the Department of Justice and representatives of numerous state governments (including New York), announced that they had uncovered a nationwide scheme directed at infant dental patients and the Medicaid system.

A dental clinic chain known as 'Small Smiles', operating in twenty-two states including New York - performed unnecessary, inappropriate, unsafe and excessive dental procedures on young children. It received hundreds of millions of taxpayer dollars."     

Zukoski says he was treated at the clinic in suburban Albany from 2005 to 2007, when he was 13 to 15.     

During that time, he says, he got 12 fillings, a pulpotomy and crown, two extractions, four temporary crowns and two root canals.     

Sometimes X-rays were taken and sometimes not, but "treatments that were needed, including steps to prevent decay or its spread, were ignored," he says in the complaint.     Zukoski claims he "received treatment ... that was below the applicable standard of care and caused him to suffer injuries" at the hands of defendants Small Smiles Dentistry of Albany, Albany Access Dentistry, and dentists Maziar Izadi, Evan Goldstein and Judith Mori.     

He also sued an umbrella defendant called Old FORBA and a handful of dentists and others who organized and served as officers of the entities that comprised it.  

Medicaid Dental Fraud–Possible Scammers include Rotten Dentists, Gov. Perry, His Contractors and the Revolving Door.

Possible Scammers Include Rotten Dentists,
Gov. Perry, His Contractor & the Revolving Door

Governor Rick Perry denounced Obamacare’s insurance exchanges and Medicaid expansions this summer. Calling Medicaid “a failed program,” he compared expanding it to “adding a thousand people to the Titanic.”1 Now it seems as though Perry may have known more about Medicaid failure—and steering that particular Titantic—than he revealed at the time.

READ IT HERE

Besides state Dental Boards not policing their dentists as they should, the Department of Health and OSHA are failing as well.

Dr. Thomas Floyd, the brute dentist in Florida, arrested two weeks ago for beating up a 4 year-old child, was also found to operate a dental clinic in extremely unsanitary conditions.  One parent I spoke with said Dr. Floyd would not sanitize the stainless steel crowns when he was trying to find the right fit – in one child’s mouth, then another’s. He didn’t change gloves from patient to patient, nor did he sanitize his instruments. When the state finally got off their butts and went to check on these allegation – allegation that had gone on for 5 years – they discovered his facility to be a hazard. (I hope all the children who have seen this dentist are receiving blood tests!)
It appears Florida is not the only state NOT checking on dental offices. South Carolina, another state that allows dental mills to run amok doesn’t check either. I bet they check tattoo parlors!

Dentists face no routine checks
September 20,2012

Written by 
Mike Foley
Staff writer

The South Carolina Department of Labor, Licensing and Regulation last year conducted 4,626 routine inspections of cosmetologists and barbers.
During that same time, the agency conducted zero routine inspections of the state’s dentists. The South Carolina Board of Dentistry — which falls under the agency’s jurisdiction — also conducted no routine inspections. The hands-off situation extended to two other state agencies: The Department of Health and Environmental Control and the Occupational Safety and Health Administration.
Yet right now, while each of those regulatory boards handles some regulatory aspect over dentists or dental practices, routine inspections are not included.
The Board of Dentistry conducts licensing exams and annual registration of dentists, dental hygienists, dental laboratory technicians and ortho-technicians. It also, investigates complaints and conducts disciplinary hearings.
Under the South Carolina OSHA, dentist offices are subject to the federal safety standards such as the “Bloodborne Pathogens Standard” and guidelines for X-ray machines. Employees must safeguard themselves with gloves, face and eye protection and gowns, but no routine inspections are conducted for compliance.
This leaves the state’s dentists solely responsible for infection control in their own facilities, responsible for patient safety, for their own safety and for the safety of their staff. Yet, while some local dentists interviewed said precautions and regulations in place protect patients, they wouldn’t be averse to routine inspections.

Can someone be paid to be a jumping up and down idiot? Yes! Here’s proof.

If Pigs Could Fly And Dental Professionals Could Be Turned Bad By Private Equity Investment
Thomas A. Climo

A NONSENSE ARGUMENT MORE IN TUNE WITH LOBBYING THAN COMMON SENSE
On May 30, 2012, DrBicuspid.com provided an article written by Donna Domino, features editor. It was titled “Private equity firms eye big profits in dentistry.” Ms. Domino was the second journalist to reach out to me that month. The first was Sydney Freedberg of Bloomsberg, whose piece was “Dental abuse seen driven by private equity investments” on May 16.

Both journalists were nice, courteous, and consummate professionals. I want to make clear that although I believe I was very helpful in providing them with data and insight from my consulting of both group and solo dental practices, I did not say one negative word about private equity investment into dentistry.

A third journalist, Josh Kosman of the New York Post, will confirm this, even though he also wrote an article with the provocative title that replaced an “S” with a “$” entitled “Private equity firms $ink teeth into dentistry,” published August 27, 2010.

The exaggerations contained in all three articles tying private equity investment to bad dentistry are only anecdotal, and not supported by serious statistical numbers.

But…but…but “Equivalent PhD, Climo, you said, and I’ll quote:

“…private-equity firms are likely to work dentists longer once they take over practices to boost profits and that could lead to worse service.”

 

The Great Dental Surgery Fraud of 2012

The Great Dental Surgery Fraud of 2012
September 6, 2012

So, remember a while ago when I told you that Little Man had 13 cavities and would need oral surgery?  Well, that has turned into something resembling a three ring circus.  I will just say right off the bat that I don't really care for the dental office but we didn't have many choices for dentists who accept Medicaid.  They didn't do anything overtly wrong, per se, it was more of a mother's intuition.

After the appointment where they told me he practically needed a whole new set of teeth, a woman in scrubs (I have no idea who she was or what her job function is) whisked me into a conference room, had me sign a bunch of papers, called the surgery center and had an appointment for Little Man's surgery within a matter of 10 minutes.  Seriously.  I felt like I was at a used car lot!  Once I had finished signing the papers, scrub woman asked me who would be signing the consent for him to go under anesthesia.  I said that it would be his DHS worker since DHS is his legal guardian.  Fine, no problem.  They'd call her and get her to sign the papers, which they did.  His surgery was supposed to be yesterday.
The day before the surgery, as I am walking out the door with five children in tow to take two to their first day of school, my cell phone rings.  When I check the voicemail later, there is a message from Little Man's DHS worker but, because it was cutting in and out, all I got was something about her not being able to make it to the surgery the next day.  Um, okay.  I didn't think she would.  Then I received a call from the surgery center telling me that we would have to reschedule because the DHS worker was "unwilling" to sign over legal guardianship to me for the day so he could get surgery.  Um, okay.  What the WHAT?!  A judge is in charge of assigning guardianship...what is this woman talking about?!

Read this mom’s entire story on her blog “It’s a Vertical Life”

10 year old Marcos Tirado’s dad says no one tried to save his son

 

• Father claims no one tried to save his son
• Six Links of Survival @ RMBF

• TSBDE Letter: Patient Death/Injury/Hospital

• Dental Sedation Responsible For At Least 31 Child Deaths Over 15 Years

Heartland Dental–Rick Workman paid $3 mil to settle fraud charged in 2008; May 2012 they got their $3 million back

On May 23, 2012, Rick Workman breaks ground on a HUGE expansion for their corporate headquarters in Effing-no-where, IL. Part of the new facility will be for “training” purposes and I’m sure the psychiatric department will have new offices. Psychiatric department you ask? Yes, that’s what I’m told. If you can’t maintain your production numbers, they actually have psychologists come for a little chit chat. A little couch time, so to speak.

Now,less than 4 months later, Workman has put Heartland up for sale, asking price… a mere $1.4 BILLION dollars.

To here him tell it, he just leases the use of some appointment scheduling software, that he doesn’t even own, and does some payroll services for independent dental clinics. (liar, liar, pants on fire…) 

I’m sure the folks of Illinois are tickled pink to give Workman his $3 million dollars back for his “expansion”.  ( $3 mil is the EXACT amount Heartland had to pay to settle fraud allegations in 2008.) Did anyone hear the “Kennedy” tone in the voice?

HOMES 

In Effingham, IL Richard Eugene and Angie Workman’s home is located at 16130 Hildene Drive, Effingham, IL 62401

4-Year-Old Given Double Root Canal by School Dentist Without Parents' Permission

Posted by Jeanne Sager on September 13, 2012 at 9:57 AM

There's such a huge pile of forms to fill out when our kids go back to school that you kind of lose track: am I signing up to be a school trip chaperone here or am I signing my life away? You might be tempted to rush right through them all. But the story of a little boy was given two unnecessary root canals by a dentist in his school's art room -- without his parents being consulted -- should be enough to kill that temptation.

Stacey Gagnon did agree to let her son Isaac get a basic examination from a dentist at school. Who can blame her? It seems like smart parenting to me. Which is why what happened to this little guy is so scary.

Stacey and husband Darren say Isaac didn't "just" get a basic examination. They say a dentist who they'd never met took their 4-year-old into the school art room and performed not one but two root canals and put in two steel crowns. The Gagnons say no anesthesia was used to numb the little man's pain. Instead they allege that three adults held him down as he kicked, screamed, and gagged. Not surprisingly they say their son now has night terrors and a desperate fear of "the dentist man."

That right there makes me furious. There is no excuse for terrifying and torturing a child. Even if this were something the parents had said "OK" to, even if this were in a professional dentist's office, that's out of line. Kids deserve to be treated with the same care as adults.

But hold your fury. It's about to get worse: the Gagnons say they never received a call asking for the go-ahead to do these procedures, and a pediatric dentist hired by the Gagnons says he doesn't see why these procedures were performed in the first place.

So a child was tortured (because, yes, that's what a root canal without anesthesia is) for nothing? NOTHING? AND his parents weren't told?

I can't say for sure, but it sounds like some greedy dentist was hoping to make more money off of the school district. And picking a 4-year-old makes sense: they are so young they don't know to say no or ask someone to call their Mom.

But as the Gagnons wage a lawsuit against the dentist for malpractice, I keep going back to what Stacey agreed to for Isaac. It sounds like she was doing what we all do: saying, hey, sure, free medical care for the kid!

I know I sign my daughter up for a free in-school cleaning every year because it's added protection for her little mouth. Because we live in such a poor district, we can even get free fluoride treatments for our kids.

But the more I think about it, the more I realize the forms we get for these kinds of things from our school districts are pretty vague. Do we really know what we're getting our kids into when they're away from us for long hours and we can't step in to care for them?

I hope the Gagnons have a good lawyer who can sort this out and get some justice for little Isaac, but it's a good lesson to the rest of us to double and triple check those forms.

Do you allow your child's school to perform dental work on your kids? Does this story impact your decisions?

Head on over to 'The Stir” and read all the comments by moms.  Mom’s are outraged.

Inside Edition airs the Isaac Gagnon story and the dangers of mobile dental clinics.

 

Morgan Stanley, the true backers of ReachOut Healthcare America and their nasty mobile dental dungeons have been on this site several times the last few days. So has their PR people. Are they worried?

Shocked is more like it. I’m told their attorney’s about flipped, when they saw their employee, Dr. Alvin Coon, DDS attempt to hit the reporter with his car. I guess someone failed to mention that to them. Wonder what other surprises are in store.

Features the parents of little Isaac and the nightmares which haunt him; the mean dentist who “got” Isaac - Dr. Alvin Coon attempting to run over the reporter: and an Interview with the Gagnon family’s attorney, James Moriarty.

If you have inside information, are an ex-employee - like the one in this story- who wants to stop this child abuse or a parent whose child has suffered at the hands of these Mobile Dental vans, please email me. Surely we can stop this child abuse together.

Here is Inside Edition’s report:

INSIDE EDITION Investigates Mobile Dentistry
Aired September 11, 2012

It sounds like a good idea - mobile dentists sent to schools to provide dental care for needy children in classrooms and school parking lots. But some families are now crying foul, saying their kids were harmed by dentists drilling for dollars.

 
Darren and Stacey Gagnon say their four-year-old son Isaac was given two baby root canals and two steel crowns by a dentist scheduled to visit Isaac’s school after the school contracted with a company called ReachOut Healthcare America.

What’s worse, say the Gagnon’s, is that the dentist, Dr. Alvin Coon (who they never met) performed the operations without their consent in of all places - the school’ art room in Camp Verde, AZ.

“I couldn’t believe that they were doing these procedures in a classroom,” said Stacy Gagnon.

She also says Isaac was never given any anesthetic or medication to numb the pain.

 

Fake dentist, Humberto Perez, arrested, along with his wife and daughter.

Appears the Miami police are in the dentist arresting business this week. They have nabbed themselves another one today, adding Humberto Perez to the list along with Dr. Thomas Floyd. Arrested today were, Humberto Perez, 81, Maria Perez, 69 and their daughter, Odalis Hernadez Perez, 41.

---

Humberto Perez arrest affidavit.

By

Crimesider Staff

Topics

Daily Blotter

(CBS) MIAMI, Fla.- Three people are being charged with child abuse after a dentist operating out of a home permanently disfigured a 14-year-old girl's teeth, CBS Miami reports.
On Wednesday, Miami police busted a couple and their daughter at their 'dental office' in Little Havana. 
Humberto Perez, 81, Maria Perez, 69, and Odalis Hernandez-Perez, 41, were all charged with performing dental services without a license along with two charges of child abuse, a statement from Miami police spokeswoman Officer Kenia Reyes read.
The child abuse charges came after a 14-year-old's mother reported her daughter's teeth were permanently disfigured following her appointment at the clinic.
While the girl's mother and grandmother say that they saw a fully operational dentist office, Major David Magnusson of the Miami Police described the room as, "everything a dentist's office should not be."
The 14-year-old described the room to police as small, and full of pots, medical instruments and teeth.
As Humberto Perez conducted dental work on the girl, she reported feeling weak and sick. According to Perez's affidavit, he injected a syringe of prescription medication into her mouth and then started filing down her teeth.
The affidavit alleges that's when the girl told Perez she felt uncontrollable pain. Perez continued with the dental procedure anyway.
The arrest affidavit for Perez's daughter claims the 41-year-old told her dad, "Dad, I hate when you work on children. They always put on a show with the crying."
The girl lost several teeth during her two visits to the office and suffered from an infection that caused her teeth to separate from her gums. She is now being treated by a qualified doctor.
"The licensed dentist said that in his 30 years of experience, he has never seen anything as horrible as what they have done to this girl," Maj. Magnusson said.
 

Dr. Thomas Floyd–more parents stepping forward with horror stories

As what usually happens, when a local news station airs the stories on children being abused by evil child abusing dentists, more parents come forward. So goes the case in Florida of Dr. Thomas Floyd.
Last evening, more parents have come forward, one parent whose child suffered being gut punched by Dr. Thomas Floyd 11 years ago, when her child was 3 years old.
Apparently Dr. Thomas Floyd has been a very very bad man for many years. Sucker punching innocent children, beating them black and blue. Busting their lips wide open. Parents have filed complaint, up to 25 in the last five years alone. What has the police in West Palm Beach, Florida done about this over the years, not one damn thing!
Apparently, the authorities in Florida think it’s perfectly reasonable for a man to beat children if he has some initials after his name, and someone refers to his as “doctor”.  What have the employees of Dr. Thomas Floyd done over the years? They have assisted in the child abuse as far as I’m concerned and are just as guilty as he is! Shame on each and every one of you – from Dr. Thomas Floyd all the way down to the county/district attorney who has done NOTHING!


Rest assured there are thousand of children this man has beaten, punched, smacked, slapped and no telling what else over the years.  Has he waterboarded children like, Megann Scott in Oklahoma? Yes, he probably has.
[Update, September 11, 2012 2:42PM
Just confirmed that this Dr. Thomas Floyd was in fact the dentist I was contacted about. I will also have to nibble on my words, and I don't mind doing that. It was people working at the clinic who took pictures and have evidence to nail this bastard.

For those who did, Big Round of Applause!!! For those who didn't, shame on them. Now, for the slow ass response from authorities, every child who was beaten since they were alerts, well, they have some responsibility in that! ]
More patients of dentist accused of abuse coming forward

WEST PALM BEACH -- More allegations have come to light involving a West Palm Beach children's dentist.

Dr. Thomas Floyd was arrested last week for child abuse, for allegedly punching a 4-year-old boy in the mouth back in May of 2010. Now another parent says her child was punched too.

Crystal Rolle of West Palm Beach says in February of 2001, Dr. Floyd punched her daughter in the stomach when she was only 3-years-old to make her stop crying.

The girl, who's now 14, remembers what happened. Aaliyah Rolle, Dr. Floyd's former patient says, “He punched me and then he punched me again and I think I was crying more and screaming.”

Crystal Rolle, Aaliyah's mother says, “I don't think he should have anything to do with children or anyone for that matter.”

Crystal says Dr. Floyd was not charged in that incident 11 years ago, because police told her they didn't have enough evidence.  There were no eyewitnesses and police couldn't take the word of a 3-year-old. Dr. Floyd is free on $3000 bond.
He denies abusing any children and says he's innocent.

The Department of Health suspended Floyd’s license to practice dentistry after his arrest Friday.

Inside Edition–Dentist on Wheels–Shows Dr. Alvin Coon of ReachOut Healthcare America, run over the reporter!

WATCH – September 11, 2012

Dr. Thomas Floyd, arrest for beating up a 4 year old in his dental office.

A mom contacted me last fall about this guy. At least I think this was the dentist.  She was working hard to get him arrested.

 

 

STATE, POLICE: West Palm Beach pediatric dentist Thomas Floyd beat up 4-year-old patient, abused others

By Scott T. Smith / CBS12.com
WEST PALM BEACH, Fla. -- A West Palm Beach pediatric dentist has been arrested on a child abuse charge, accused of beating up a 4-year-old boy during a dental procedure in 2010.

Thomas P. Floyd, 61, of 258 Golden River Drive in Tequesta, was booked into the Palm Beach County Jail Friday afternoon, and state officials issued an emergency order to suspend his license to practice dentistry, with multiple allegations of further abusive incidents involving other children (details below).
The state also alleges he used unhygienic practices, including failing to change gloves or instruments between patients.

About 25 complaints have been filed against Floyd with West Palm Beach Police since 2006, the state noted.

According to a probable cause affidavit for Floyd's arrest, West Palm Beach Police responded to a 9-1-1 call on May 5, 2010, from Floyd's office at 400 Executive Center. Witnesses reported hearing a child screaming and crying in one of the exam rooms and the boy later told police that "the doctor went pow pow on my face" ... "and it hurt."

At the time, no employees said they witnessed the incident, but several advised "this was an ongoing problem with Floyd being physically abusive to patients."

The responding officer noted the child had an injured lip, but Floyd said the child bit it during a procedure to cap several teeth.

 
The child's mother took photos of the injuries and took him to the pediatric unit at St. Mary's Medical Center, where records noted the boy had a tear under his tongue, multiple cuts on his lips and a laceration on his gums. His lips were swollen and had dried blood on them.

An investigator met with the mother and child on April 5, and a Child Protection Team interviewed him a week later and his stories were consistent that the dentist had hit him in the face several times.

 

I believe Inside Edition will be airing a program tomorrow, September 11, 2012 about mobile dental clinics, specifically ReachOut Healthcare America.

Deaths and dental care, could this be one of the problems?

Dennis Yamashita DDS, Chairman and Director of Oral and Maxillofacial Surgery at Los Angeles County/USC, Ostrow School of Dentistry at USC, and Children's Hospital Los Angeles, is charged with incompetence, gross negligence, and multiple counts of negligence for his treatment of a 44 year old who died under general anesthesia that he administered while performing a biopsy in his office in 2009. Dr Yamashita has been involved in the training of dental oral surgery residents for many years in Los Angeles and currently remains at this position as the Program Chairman and Residency Director at USC and affiliated hospitals.


The California State Dental Board, according to an online public record released a few months ago on its website (http://www.dbc.ca.gov/) is moving to revoke his license to practice and general anesthesia privileges for incompetence -- presumably for treating this patient without prior consultation or consideration of her extremely high blood pressure and other medical problems that resulted in her having suffering a stroke under his care, failing to do a proper medical examination prior to anesthesia, failure to control the patient's high blood pressure on two occasions (she had had a prior surgery at his office a year before), failure to keep proper records during the surgery and anesthesia, and failure to call emergency services until 7 hours after the surgery and anesthesia were completed.


Is this the role model of the standard of care representing our current crop of dental trainees?

Child dies while being sedated at the office of Dr. Juan D. Villareal, Harlingen, Texas

While being sedated at this man’s office -  Dr. Juan D. Villarreal…

 

 

 

 

…this 10 year old boy, Marcos Tirado…died…basically euthanized.

 

 

 

 

…at this place, Harlingen Family Dentistry, Harlingen, Texas

 

 

 

Read more: Local, News, Boy in Coma, Boy Dies, Tooth Filling, Dental Procedure, Marcos Tirado, Anesthesia, Trinity Baptist Hospital, Loss of a Child, Harlingen, Cameron County, Harlingen Family Dentistry, Treacher Collins Syndrome, Valley Baptist Medical Center, Death of Marcos Tirado, 10 Year Old Dies, Federal Patient Privacy Laws, Lamar Elementary School Third Grader, Lamar Elementary School, Dixieland Road

Just minutes after 10-year-old Marcos Tirado received anesthesia at a local dental office, he was rushed to the hospital.

The Lamar Elementary School fifth-grader died two days later. 

It’s a pain no parent wants to endure. 

The loss of a child, that’s too young to be gone.  It’s a hard reality for the Tirado family in Harlingen. 

He was undergoing a  tooth filling at Harlingen Family Dentistry off Dixieland Road.

"Every time there was a procedure there was a lot of precautions that had to be done, the time we took him to the dentist, the doctor said it was a simple procedure, but obviously is wasn't." said Marcos Tirado, Sr.

Marcos had a medical condition called Treacher-Collins syndrome; and certain precautions need to be followed. 

The family said they made doctors and nurses aware before the procedure. 

When they were told Marcos would need to use a gas to keep him calm. 

His father showed concern but says the staff assured him it was perfectly safe and routine. 

But 10 minutes into the procedure, something went terribly wrong.

"I thought he was in just a little pain, but obviously he was unable to breathe, he just stopped," the grieving father said.

Marcos was rushed to the Valley Baptist Medical Center in Harlingen where doctors were able to revive him.

He stayed in a coma as his parents prayed for a miracle. 

But by Wednesday evening, Marcos passed away leaving his family heartbroken.

"He was with us for 10 years and even though he went thru a lot medically he was a happy boy,” the boy’s father recalled. “He surprised us many times but when it’s time to go God gives the call..that's what it is, we'll respect that."

Action 4 News contacted the Harlingen Family Dentistry for comment.

They said they were deeply saddened to learn of the death of Marcos Tirado, Jr. but due to federal patient privacy laws, they said limited information could be given. 

“Our thoughts and prayers are with the parents and their family at this difficult time,” they said in a statement.

Is Rick Workman trying to dump his baby - Heartland Dental - before its value is zero?

Many in the industry don’t see it.  Even more are in denial about it. But it’s happening, non-the-less. Corporate Dentistry is under attack. Federal, state and local governing boards as well as law enforcement agencies are making bold moves to clean up what has been left to run amok for years. This “clean up” may be fatal. Which is fantastic for every person in America, because everyone sees the dentist at some point.

Though it may be slow and painful. Has Rick Workman finally come to gripes with that reality? I think this is a HUGE signal to all “corporate dental chains” out there. When one of the first, largest and most influential entities in the industry is ready to tuck it’s tail and run, you know it’s bad.

 

Heartland Dental Care, Inc. Sale
September 6, 2012
Heartland Dental Care Inc., one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter, Reuters wrote Thursday. The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.
(Reuters) – Heartland Dental Care Inc, one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter.

The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.

The sources asked not to be identified because the process is not public.
Heartland Dental has about $120 million in annual earnings before interest, tax, depreciation and amortization (EBITDA) and could be sold for 10 to 12 times EBITDA, they added.

The auction is early in the second round and final bids are expected about a month from now, according to the people. Jefferies has offered to provide financing for potential buyers, they added.

Representatives for Heartland Dental, CHS Capital, Jefferies and Moelis did not immediately respond to requests for comment.