Tuesday, May 20, 2008

Kentucky Should Close Down, Small Smiles, Ocean Dental and Kool Smiles, They Are Operating Illegal Clinics

I would say Small Smiles and Ocean Dental and apparently Kool Smiles, since it's planning on opening up a clinic as well, in Louisville are walking a fine line according to KAR (Kentucky Administrative Regulations) Title 201.


201 KAR 8:006 prohibits a dentist from using
false, misleading, or deceptive advertising and also
establishes the rules for dentists to advertise as
specialists or as being especially qualified in any
area of dentistry.


All dental advertisements shall contain the name of
each licensed dentist providing services within that
practice.

Further, a dentist shall not use the name of a
dentist who does not have an ownership interest or
any association in the dental practice. A dentist
who purchases the dental practice of another
dentist shall not use the name of the seller for
more than one (1) year after the purchase of the
practice. Also, a dentist shall not use the name of
another dentist who formerly practiced as a
partner, after the termination of that partner’s
ownership interest in the dental practice.

Any licensed Kentucky dentist may submit their
proposed advertising to the Kentucky Board of
Dentistry for written approval prior to using the
advertising.


Plus according to other rules, a dentist is Kentucky must actively participate, and something tells me the owners of these clinics don't actively participate in the practice of dentistry in Kentucky.


Kentucky Dental Association Stops Small Smiles from Patient Shopping

November 2007


Dr. Jim Allen, DMD moved to disapprove Dr. Tony Quiroa’srequest for Board approval for hygienists from Small Smiles of Louisville to conduct dental screening services at various elementary schools. Dr. Gaskill seconded the motion. All were in favor.


Kudo's to the Kentucky Dental Board but should Small Smiles even be in the state. If they weren't, there would be no need to stop them from sending out a hygienists to patient shop as they have been found to do in other states.

I realize this is was last fall however the Kentucky Dental Board has not issued another newsletter at this time. They meet in Spring and Fall of each year.


Saturday, May 17, 2008

Hawaii's HB 2301 Leaves Dental Mills On The Main Land.

It appears Hawaii is doing all it can to protect their citizens from Medicaid dental mills such as Small Smiles, Kool Smiles, Ocean Dental, and Western Dental.
Hawaii has a law in place that says “a dentist must own, maintain or operate an office for the practice of dentistry.” However the laws as they stand now do leave a “loop hole”, as in other states, that people like Michael DeRose of Small Smiles and Dr. Tran Pham of Kool Smiles seem to find a way to slither through.

Majority Leader Kirk Caldwell's HB 2301 bill to prohibit "interference in the practice of dentistry by an unlicensed person or entity" and prohibit "the practice of dentistry in a commercial or mercantile establishment"

Jeffrey Miyazawa, D.D.S., Chair of the Board of Dental Examiners opposes the bill, no big surprise there, but other dentists of Hawaii fully support it.
Dr. Miyazawa argues that passing this law would not give the board any power to enforce it, and I’m saying to myself, "why the hell not?"
Dr. Miyazawa also says “HRS 448-17(a)(12) provides for sanctioning "any other improper, unprofessional, or dishonorable conduct in the practice of dentistry.”
Provisions like this or something close is on the books in most all states, and it hasn’t done one thing to stop these Medicaid dental mills, slowed them down one bit, or even caused them to pause for a split second despite the hundreds and hundreds of complaints and reports.
Hawaii’s HB 2301 would amend HRS 448-A to include as follows:
(a) No person or entity without a license issued pursuant to this chapter shall direct or interfere with a licensed dentist's judgment and competent practice of dentistry.
(b) No dentist licensed pursuant to this chapter who engages in the practice of dentistry in any form, shall permit a person or entity, other than a dentist licensed pursuant to this chapter, to direct, participate in, or interfere with the licensee's practice of dentistry.
Section B above certainly would limit that quota and bonus system that the dental mills have established in other states now wouldn’t it?
HB 2301 would also add 448-B to read as follows:
No person licensed pursuant to this chapter shall engage in the practice of dentistry in a commercial or mercantile establishment, or advertise, either in person or through any commercial or mercantile establishment, that the person is a licensed practitioner and is practicing or will practice dentistry in a commercial or mercantile establishment.


This section shall not prohibit the rendering of professional services to the officers and employees of any person, firm, or corporation by a dentist, whether or not the compensation for the service is paid by the officers and employees, or by the employer, or jointly by all or any of them. For the purposes of this section, the term "commercial or mercantile establishment" means a business enterprise engaged in the selling of commodities or services unrelated to the practice of dentistry or other healing arts.

I think this is a great beginning to an end of the dental mills and I would suggest everyone who reads this and its language to get with their state law makers and get something like this or close to it passed in their respective states.
One thing that is not addressed in this bill is the use of papoose boards. I understand people think the Dental Board would regulate this since the ADA and the AAPD have "guidelines" however leaving things like this to "Boards" of dentists' own peers simply isn't working.
I’ve already started that quest in my state and I can’t urge my many loyal readers enough to do it in your own.

update 3-2010:
I've written to Rep. Caldwell, who at present is running for Mayor of Honolulu to see what happened to his bill.

I did find this:

HB 2301 HD1, Relating To Dentistry
Majority Leader Kirk Caldwell's bill to prohibit "interference in the practice of dentistry by an unlicensed person or entity" and prohibit "the practice of dentistry in a commercial or mercantile establishment" was characterized on the Floor by Rep. Gene Ward as "the anti-Wal Mart, anti-Big Box bill" who went on to say that it was a premature, misplaced constraint of trade. The bill passed, with Rep. Ward as the only no vote.



Kool Smiles Terra Haute Ex Employee's Comment

If you have had issues with the Kool Smiles in Terra Haute, IN clinic contact me at cckaddie@yahoo.com.

Here an ex-employee comment on that clinic:

I just want to say that the same treatment and experiences that have happened in Atlanta are somewhat identical to the office in Terre Haute, Indiana. The CTL isn't x-ray certified, along with the other dental staff are not x-ray certified.(So how can she train those who aren't?) Looks like someone didn't do their homework!! Deadlines for xray certifications is running out!!

The CTL was also caught rough handling a 3 yr child approx. 2 months ago in front of the parent, Office Manager and other dental staff, but nothing was done.The Office Manager loves to lie to HR. Their day will soon come!

Michael DeRose and the Root Dental Management-Rafael Rivera, DDS, PLLC Connection

Root Dental Management is part of the so called "new owner's/new management of Smile Starters" in North Carolina. There are current ads throughout the internet for dentists, assistants and other office personnel wanted for Smile Starters that is under this laughable "new owner's/new management" concept they (being the DeRose's) are trying to sell to the good citizens of North Carolina.

Here is the contact info for applying for a job with Smile Starters:

Roger Walters
SmileStarters
2211 - E Executive Street
Charlotte, NC 28208
704-395-6000
walters.rdm@gmail.com


Same physical Address as Root Dental Management and note the email address: rdm-Root Dental Management. I bet Roger Walters could tell some stories don't you guys?

Root Dental Management is owned by Ryan Root of Pueblo, Colorado. At the North Carolina Secretary of State's website if you search for Root Dental Management this is what you get:

Registered in North Carolina: 3/21/07
Formed in Delaware: 2/20/2007
President: Ryan P. Root
Agent is: Ryan P. Root
Registered Address is:
2211-E Executive St
Charlotte NC 28208

Principal Office is:
2211-E Executive St
Charlotte NC 28208

Principal Mailing Address is:
PO Box 816
Pueblo CO 81002

For those of you who don't remember, Ryan Root and the exact same address is the contact for Michael A. DeRose, DDS, PA on the Health Care Reform Act List of Electors in New York State.

See Here

Rice Root Accounting in Pueblo is the old accounting firm for the DeRose's until they got big enough to need an in-house accountant. That's when Ryan slithered on over to work solely on DeRose stuff.

One person sticking up for Rafael Rivera, Jr. who is supposed to be the new "owner" of Smile Starters (whom I think was closely related to Raf, said on this very blog, Raf had worked for SmileStarters as far back as 2002 or there about.

If someone could get their hands on a copy of that "sale contract" with Dr. Rafael Rivera, Jr., Dr. Michael A. DeRose, and Tish Ballance (which would be the sale between Ballance DeRose, DDS, PA and Rafael Rivera, Jr. DDS, PLLC-formed 2/18/2008) you are going to find that Michael DeRose is a "consultant" of sorts and will be getting a hefty fee for his laughable and knowledgeable input!

And next year on Michael A DeRose's many tax returns there should be a fee listed from Rafael Rivera, Jr. DDS, PLLC dba Smile Starters or there is some very creative bookkeeping going on!

Of course it will probably be listed as pass thru income (yeah, passing through umpteen million) LLC, Corporations and PA before it lands on his and his wife's person tax return. But I guarantee it will be on there somewhere, just like a few other corporate dental organizations "consulting fees".

Here's another thought:
It's customary when there is a sale of a company like this between two professionals (sorry...peed my pants laughing...when I typed the word professional) for there to be a "non compete" clause. Yet, here we have Tish Ballance already (even prior to the official signing of the documents) opening up Access West, another medicaid dental practice not far from Dr. Rivera's Smile Starters.

You know, when something stinks it stinks no matter how you twist and turn it, flip or flop it or try to hide it doesn't it?






Thursday, May 15, 2008

Small Smiles Temp Dentist Speaks-Reposted From A Dental Forum

I just returned from a 6 week assignment from a temporary agency to a small smiles clinic. (Assignment cut short because FORBA decided not to use doctors that were not credentialed with medicare) In any event, The biggest question I had was....Why mom or dad were not back here learning how to care for the children's teeth. Then I find they are not allowed back there. I was disgusted with the way the children were treated. I wouldn't take a dead snake to that place.

While my office is being built, I decided to make a little money in the interim. I happened to use a temp. service that put me in a small smiles clinic. I was informed by the lead dentist that this was the last place many of the patients could go for dental services, "that we had to do what was necessary to get the job done." This sort of tugged at my heart to see these kids with so much decay and infection. Out of the five doctors that where available, I had the most experience with respect to years practiced. Most were recent grads.

We probably averaged 20 -25% usage of the papoose. It was a screaming frenzy for those few patients that did get the papoose. I did inquire "why oral sedation was not used" and was told that it was not a covered event for the Medicaid patient. From a business view point, they make a lot of cash. Even with the new doctors, it gave me the impression that it is sort of like an uncontrolled residency and a quick way of bringing your skills up to par before entering the "outside world".

They train their own assistants for the most part, because of the high turnover rate. Compensation to them is minimal. They do get enticed with a monthly bonus. I was told that they average 16K production a day. From what I saw, they must do most of that in Hygiene. I do not know what Assistants can or can not do with respect to polishing in that state, but that is used a lot. They work the assistants to the ground and they frequently have 10 hour exhaustive days. One day we saw 137 patients.

I have mixed emotions at the present time. It is obvious that a great deal of money is being made utilizing the government handout of these funds. I was told that not all states pay as well as others and that is why they are not in some of the states.

Whether or not this is true I have not investigated. They have apx. 80 offices with goals of close to 100 or so by 2009. I am not opposed to anybody making a profit. If this truly is the last stop for many of the patients, than they are performing a needed service.

Overall, you have the most inexperienced team, working on probably the hardest portion of the population. It is going to attract media attention at any given opportunity. What is the answer to the problem at hand? I can not tell you. Once again, I am grateful I am able to refer out any pediatric case.

Perhaps, instead of going to Africa, or South America all the time, we doctors can just stay home and donate our time and talents to the local community. I know that is not as glamorous as the "out of country" trip, but it certainly would be just as beneficial. Sorry, I guess I rambled at bit too much.

Kevin P. Ward, DDS-Back In Business

A New Jersey dentist, Dr. Kevin P. Ward's dental licenses were suspended November in 2000 after media reports of him breaking the leg of a child put pressure on the dental board. Until the media broke the story, the dental board had done nothing even though several other patients reported injuries and broken bones. His licenses were reinstated with limitations in 2005 according to records with the New Jersey Dental Board and in April 2007 dental board minutes I found the following:

Kevin P. Ward, DDS - Dr. Ward appeared before the Board with Richard Tanner, Esq., concerning a request for limited reinstatement of his New Jersey dental license. On July 20, 2005 Dr. Ward’s license was reinstated with restrictions. He was permitted to engage in the administrative practice of dentistry but not in the clinical practice of dentistry.
Dr. Ward discussed his administrative duties since the filing of the July 20, 2005 Order to the present. He also discussed his progress in therapy with Richard Reichbart, Ph.D., and discussed the evaluation performed by Alberto M. Goldwaser, M.D.
With regard to future plans, Dr. Ward indicated that if his license is reinstated, he would like to do part-time orthodontics on adolescent patients. He indicated that he has continually taken courses in orthodontics and sees it daily at the practice. The Board requested that he provide a copy of the proof of completion of the courses taken for this renewal period.
At the conclusion of all testimony by Dr. Ward and questions from the Board, the inquiry was ended.
The Board moved this matter to Executive Session for deliberation.
Upon returning to Public Session, the Board determined to table a decision pending receipt of a more complete report from Richard Reichbart, Ph.D. A copy of the transcript of today’s appearance will also be provided to the Board.
In October 2000 NBC's Dateline reporter Hoda Kotbe reported on Dr. Kevin Ward and the many children he had traumatized, broken bones, and even had one child, Kelly Givens, die while under his care.

By checking for his licenses it looks like he's back in business

Children's Dental Clinic,LLC is Really Small Smiles in Columbia, SC

Does anyone besides me find it just amazing at all the names FORBA/Small Smiles, Smile Starters, Medicaid Dental Centers, uses?

In Columbia, SC the IP Address leads you to Children's Dental Clinic, LLC at 3000 Two Notch Road, which when I was there Monday, had Small Smiles on the Building.

If you google Children's Dental Clinic Columbia, SC you once again get a listing for that name but the address is Small Smiles and the website listed is smallsmilesusa.com. See Here

According to a business search at the South Carolina Secretary of State's Website, the Small Smiles in Florence is Children's Dental Clinic of Florence, LLC.

The Children's Dental Clinic of Columbia, LLC (Small Smiles on Two Notch Road) filed a Domestic LLC company 2-21-2003 and is current in all it's filing. Prior to May 12, 2003 it's name was Children's Medicaid Dental of Charleston, LLC. On 8-17-2008 this was filed "
CHG AGT & ADD FR MICHAEL T SMITH".

Looks like one "Michael T. Smith" was once the registered agent for Children's Dental Clinic, (Small Smiles) as well as the Small Smiles in Florence and they were both changed to National Registered Agents, Columbia, SC.


As for the Small Smiles in Florence, SC. It was first established 1/23/2004 and it's first name was actually Florence's Children's Dental Clinic, LLC then changed it's corporate name to Children's Dental Clinic of Florence, LLC 3-5-2004, a short two months later.

In both cases, it appears these DeRose companies set up in a state as one name and with in 2-3 months change their business names. Then of course go on to operate under various other names.

Honestly, it must take an army to keep track of all of the names. I bet if you asked the employees who they worked for, they might be able to come up with some name, but it probably isn't the right one.



Does anyone on here remember Dr. Kevin P. Ward who amazingly had a child break his leg (the femur bone) while in a dental chair at the Children's Dental Center of Union City, New Jersey back in February of 2000? Another child came out of his office with a broken wrist. The state revoked his license for a short time for injuring 13 children. Look at the name of this clinic!


Tuesday, May 13, 2008

Ocean Dental's Chad Hoecker Desciplined in Ohio

Ohio Dental Board Disciplinary Action

CHAD B. HOECKER, D.D.S.
Motion by Dr. Kyger, second by Dr. Armstrong, to approve the proposed
consent agreement for Chad B. Hoecker, D.D.S., license number 30-022103, case
number 06-18-0603.

Motion carried.

I don't know what the complaint or disciplinary action was but the case number is listed above. Chad Hoecker is the owner of Ocean Dental Corporation, another medicaid dental mill.

Small Smiles In Boise, ID Employee Speaks Anonymously

Take it from a Small Smiles employee of many years who does not recommend anyone she knows nor lets her own children come to this place, do not bother going there.

It depends on the doctors mood that day if parents are allowed to come back, we are encouraged as assistants to make excuses as to why you cannot. Personally, I do not make excuses, I just let everyone come back if they ask and let the doctor look me in the eye because the policy states that one person may accompany the child back.

It is a very rushed system like a cattle call consisting of a morning meeting of the quota that needs to be made. "Oh, you did 98 patients yesterday that is down from the day before so you need to get it up if you want your bonus." Well screw the bonus if the kids are not getting the care that they need and are being rushed out and treated as if they are just a number.

This is exactly how everything including the employees are treated - all just numbers. Lets all just compete. If you complain or think that something is upsetting you might as well kiss your job goodbye. Welcome to Small Smiles.

There are no pediatric dentists and there never have been. All the dentists get trained in the Pueblo clinic in about a week to handle children and most of the assistants are hired of the street with little no training, which makes it wonderful for the rest of us that actually have training and know how to do things the right way by sterilizing instruments and treating children well.

Many of the good assistants are on our way to getting out of this "dental office" and on our way to bigger and better things. I just can not wait until the day that Small Smiles is closed down for all their mistreatment of patients needs and care as well as the care of their employees.

My identity is hidden because that is how you have to handle things with Small Smiles as an employee.

Small Smiles of Boise, ID

208-322-3010

8744 W Fairview Ave
Boise, ID 83704

Since there are so many very unhappy employees at Small Smiles maybe it would be a good idea for someone to write the office a general letter and try to get some of these employees to step forward as Whistle Blowers. Let's face it, management isn't likely to open the mail, right?


Saturday, May 10, 2008

New York Kicking Small Smiles To The Curb

May 8, 2008
Steve Flamisch

The New York State Office of the Medicaid Inspector General is terminating Small Smiles Dentistry from the state Medicaid program effective May 24, CBS 6 News has learned.

A spokeswoman would not confirm any additional details, citing the need to preserve the integrity of the ongoing investigation.

Three former employees and the parents of 82 patients accuse the Colonie children's dentistry clinic of performing rushed and unnecessary procedures on its young patients, all to make money. The ex-employees claim the dentists and other staff members earn lucrative bonuses for achieving certain "production numbers," though the company patently denies that claim.


Government sources confirm that Attorney General Andrew Cuomo's office is also investigating Small Smiles. Cuomo has the power to bring civil and criminal charges in Medicaid cases, though it remains to be seen whether that will be the case.

The State Education Department, which licenses all dentists in New York, would not confirm an investigation, but did file a subpoena requesting all of the information CBS 6 uncovered. The station is cooperating, and - at the request of the parents - sharing that documentation with other state agencies, as well.

Small Smiles spokesman Don Meyer would not confirm the state's action, nor would he explain how 82 parents had come forward to corroborate allegations the company has dismissed as "baseless." In an email, Meyer said, "I have no additional information to share with you at this time."

Video Interview of Parent Forum

Finally a state has stepped forward and working on putting an end to Small Smiles/FORBA barbaric back alley dentistry and abusing children in the process.


I'm looking for more states to follow New York's lead in the near future. Let all keep our fingers crossed and hope that North Carolina realizes Smile Starters is owned and operated by the same people and kicks Smile Starters to the curb as well.

Ok, let see what states follows New Yorks lead.

Next?

On a side note:

Dr. Randall W. Ellis, DDS referred to as reviewing the patient files internally for FORBA's (Small Smiles) is a Professor at (drum roll please...... ) Creighton!! And lives.....(drum roll again)...... Pueblo!


Friday, May 09, 2008

Obtained Small Smiles Patient Information Forms

Dropped Into a Small Smiles Clinic in South Carolina today and picked up some forms to pre-fill out prior to an appointment.

See the Forms here

The main forms for the patient to fill out is manila card stock patient folder. The front part is the only part the patient or guardian fills out prior to treatment, the signs at the bottom. It's not until the folder is open that the Patient Behavior Management Procedures are listed. Long after the parent or guardian has signed and consented to treatment.

I find this a bit sneaky.

As stated this in the patient file, the parent or guardian does not take any of this info with them. You can see in the picture when the folder is open on the left hand side lists the procedures and the right side is used to document appointments, visits and work performed.

What I find very misleading is that there is only one place for the parent or guardian to sign and it's only of the front just after the patients medical history has taken. Usually if there are other sections of documents that you need to read there would be a place for initials or a signature after that all important section.

At the bottom of the front page, the only page the parent or guardian fills in it says:

I certify that I have read and understand the above. I acknowledge that my questions, if any, about the inquiries set forth have been answered to my satisfaction. I will not hold the dentist, or any other members of his/her staff, responsible for any errors or omissions that I may have made in the completion of this form. I have also read and understand the Pediatric Dentistry Patient Management Techniques on page 2 of this form and give my consent for their use.


The way this is laid out it appears that you only read and fill out the front page. When you open the file folder it appears the inside is for the dentist to record the treatments.

This is a blanket signature agreement. Sections are not laid out clearly for the parents or guardian to read, sign, and understand to the full extent as it should be.

It's very sneaky to have a place for a signature acknowledging something prior to getting to that section. I don't know that I've ever seen any kind of treatment agreement, contract or other official document that has a place to sign prior to getting there, have you?


There absolutely should be a place to sign at the bottom of the second page acknowledging the parent or guardian has read the Patient Management Techniques and a place for the dental assistant or dentist to sign under it acknowledging that "techniques" were clearly explained and demonstrated.








Small Smiles Of Aurora is 6th Street of Denver Dental Clinic, PC, a DeRose Company

Download Document Here

Small Smiles Dental Centers Of Aurora Colorado's True Name is "6th Street of Denver Dental Clinic, PC."

Note: The address is the same as the old DeRose Children's Dental Center is Nashville, TN.

Thursday, May 08, 2008

FORBA, LLC Formed 1-2002 then renamed to LIC SAC, LLC

About the exact same time the DeRose's sold the assets of FORBA, LLC they changed the name of FORBA, LLC (For Better Access) to LIC SAC, LLC. (Lick Sack, nothing but class those nasty scumbags...I mean scum sacks) 10-02-2006. Notice on the documents the address is that of DD Marketing in Pueblo.

To See the documents click here.

10-01-02
FORBA, LLC Articles Of Organization Here, see Dan DeRose's name right here!
Dan DeRose, Michael DeRose, Ed DeRose, William Mueller, and Adolph Padula.

According To The Colorado Secretary Of State Website, FORBA, LLC, named changed to LIC SAC, LLC, 10-02-2006 is listed as stated below:

5-5-2008: Entity name and any active trade names changed due to failure to file annual report

Tuesday, May 06, 2008

Small Smiles In Kansas, Just Plain Illegal.

Kansas Law States the following in regard to Corporate Dentistry:

K.S.A. 65-1435 It unlawful for any person to practice dentistry under any name except such person's own name, with two exceptions:

1. subsection (b)(2) which allows two or more dentists to associate together for the practice of dentistry in a professional corporation, organized under the professional corporation law and under a corporate name that may or may not contain the proper name of any of the dentists.

2.
(b)(3)associating together with persons licensed to practice medicine and surgery in a clinic or professional association under a name that may or may not contain the proper name of any such person or persons and may contain the word "clinic."

From the AG's Opinion:


It is clear from the prohibition in K.S.A. 1994 Supp. 65-1435 that one dentist may not practice dentistry as a professional corporation and under a corporate name unless the dentist "associates" with one or more other dentists.

The act indicates a legislative intent to protect the public from the fraudulent practice of dentistry by a corporation or under a business name that indicates there is more than one dentist in that practice when in fact there is not.

In conclusion it is our opinion that dentists who want to incorporate under a corporate name pursuant to subsection (b) (2) of K.S.A. 65-1435 must join together for the common purpose of the practice of dentistry and so long as there is more than one dentist practicing dentistry in a corporation established in accordance with the professional corporation law, the requirements of K.S.A. 1994 Supp. 65-1435 (b) (2) are met.

Read the full opinion here
Many states are not as strict with their regulations or wording which is why is some states the Corporation Umbrella that some of DeRose's clinics operate is under Michael A. DeRose, DDS PA. After he has his actual name established in those more lenient states he's ready to set up operation.

Yes, there are a couple of Small Smiles in Kansas and at present they are under fire. They say the dentists who is actually working at the clinics "own" the clinics and has a financial interest in the clinic, but that is simply not the truth. But rest assured, if FORBA/Small Smiles/DeRose can find a way, they certainly will.

Hopefully Kansas will be paying close attention, listen to their citizens and run these people out of the state on a very long, far reaching rail.

With any luck at all, more states will take Kansas's lead here and change the laws, so that if a dentist has a licenses in your state and his name in hanging on the door under whatever cute little name he wants to call "his" clinic he better see patients there, so in case of mishap you don't have to run him down across several states to nail his butt.

update:  4-21-2010
Kansas is allowing FORBA to operate clinics in it's state and doing nothing to stop it. 

















Monday, May 05, 2008

Western Dental Corporation Another Ruthless Dental Mill?

An Open Letter To Western Dental Reposted Here From The Hive Blog
Comments To Post At The Bottom, also reposted.

Here is the letter:

A letter to the corporate office of Western Dental... An absolutely INHUMANE treatment of low income patients by a facility that is advertised as caring for those with medi-cal or low income with respect and dignity AND great care... FAR FROM THE TRUTH
To whom it may concern:

Please accept this letter as my personal and adamant request for the services rendered and the absolutely filthy conditions of your Western Dental office located on Briggsmore Avenue in Modesto California to undergo some SERIOUS investigation.

I would like to explain the circumstances which have brought me to this point of complaint... and I'm doing so PRIOR to having received the full service of my initial visit due to the fact that I am absolutely livid over the way in which my dental procedure and status as a patient has been treated by various members of the Western Dental Team which has revealed itself to be an obvious standard for all other patients as well.

My reasoning for visiting WD was purely out of need to be seen on a Saturday and to get a broken tooth fixed by crown procedure prior to my private insurance undergoing changes - regular dental offices are not open on the weekends so.... I made an appointment for 8 am on Saturday, Feb. 3, 2007.

The waiting room was to capacity when I arrived by other patients who had an appointment at either the same time or very near the same time as mine. I waited for over 1/2 an hour before I was even given initial paperwork. The condition of the waiting room was filthy and the staff was beyond disorganized in the procedure of caring for those that should have come first...their patients.

Nearly an hour later I was led back to get X-rays by a very kind technician... yet obviously in a huge hurry due to the large volume of work needing to be done... as a result - I had to be re-xrayed later in the day. It was nearly two hours of my arrival that I was even seen by a doctor. He came in and told me I needed a root canal. Then upon examining my tooth - he admitted that he'd misdiagnosed and that I only had a broken tooth.. This is what I'd already written in my paperwork and had explained to each staff member that I'd come into contact... yet another obvious sign that even the doctor had far too much to do - to the point where reviewing my chart prior to seeing me hadn't even occurred. Again - this man was very kind.

The condition of the facility, was again, very dirty. From the sticky floors to the dirty containers which held materials that were eventually needed in completing my procedure. The facility appeared to not have been cleaned in a substantial amount of time.

Having NO CHOICE but to proceed with this procedure at that time was very frustrating. In all of my years of having dental work done, never before have I ever experienced such deteriorated services and poor conditions in which to have my teeth worked on. I am in full understanding that these offices are typically used by those having state funded insurance programs... to me the treatment received by those people in this office IS SHAMEFUL!!! I feel that by way of lack of care for their scheduling and the lack of cleanliness of the facility your company is essentially telling these people that A. Their time is not important and B. Since they have no other choices, or may not know that they have other choices - they are forced to be treated in filth.

I was at your office for well over three hours and had to leave prior to even getting the cleaning which comes with the service I'd received. The dentist was VERY professional, however once he finished drilling down the broken tooth he left me in the care of, once again, a VERY nice woman who admitted to me that what she was doing, fitting the temp crown, wasn't within her scope of practice... however because of the over scheduling and lack of adequate staff members, she was forced to do the work she isn't even qualified for. It took nearly another 1/2 hour for her to trim the temporary down to even fit...

After I asked if I could do the cleaning at another time as I'd been at their offices for nearly FOUR HOURS - I was clearly told that the crown would be in within 1 to 1 1/2 weeks. I stopped at the front desk - had to actually request to be helped by two staff members who clearly knew I was there yet continued with a very personal conversation - I was told that my portion of the bill would be $400 - I wrote a check for $200 and left.

Four days later the temp fell off - I visited the office that night and was again helped by the same woman..although VERY NICE... admittedly unqualified to do what she was doing. She put a stronger adhesive onto the tooth and sent me on my way.... with a huge gap between the temporary crown and the tooth itself. She said it would be ok as the permanent crown was going to arrive in a couple of days. Well... it hasn't and it's not ok.. it is painful...

Being patient and a rule follower I waited for two weeks and I phone the office to find out where the crown is - I was informed by the woman that answered the phone that no one would have told me 1 1/2 to 2 weeks as it NEVER takes less than THREE weeks to get the crown in. Having NO choice but to wait... I did and in fact have received a bill for UNDER $200 - which makes me grateful that I did not pay the full $400 that they were requesting at my initial visit.

At three weeks, this past Saturday, I phoned again - and after 20 minutes on hold and being called by the incorrect name twice - I was told that it would be yet another week until the crown arrived from the lab.

This was enough. I asked to speak with a floor supervisor and after several minutes of bantering back and forth with this woman about my right to speak with a manager regardless of when the crown would arrive she finally told me to hold on... again placed on hold for a substantial amount of time - only to have the SAME woman pick up the phone and inform me that the floor manager found the crown and it would be in on Monday - period end of sentence. I told her that I still wanted to speak to her - she told me the manager was too busy and that I needed to call her back in 15 minutes. I told her that I would appreciate her taking MY number and having her call ME back when she was free. She never did.

I did lodge a complaint with your corporate office and they were in fact kind. I was uncomfortable when I was describing the current condition of the tooth as being painful and then being corrected by your representative to be told that "oh so it's annoying you?" I received the canned standard answers that are expected when this type of customer service disaster occurs.

Here is my MAIN ISSUE...

If this is honestly the type of service that people with medical are expected to accept than I am horrified by the sad sad misrepresentation which Western Dental is pouring all over the media... had I not had the verbiage and ability to insist that I be treated with the respect that I, as a customer, paying or not paying out of my own pocket deserves.. than I would still be sitting here today with no resolution to this matter - well, in fact I am still sitting here with no resolution to this matter as I still have an improperly fitted temporary - and no absolute security that this suddenly post complaint found crown is even really found at all.

I was told by your corporate office that I was in fact the second complaint about the same property that day... how this could possibly be the first time for this to happen - I find VERY difficult to believe.

What really bothers me are the looks on the faces of the other patients in that office... knowing full well that they are being treated disrespectfully yet perhaps not having the voice or option to speak up...it was a truly truly truly disturbing experience - to make it worse.. I still have to go back there to get the permanent crown placed... I was told by corporate that the staff at the office already knows that it was me complaining to them --- this makes me highly uncomfortable for my return visit.

Western Dental Corporate Staff... I am sincerely hoping that this type of inhumane service being provided to those less fortunate than others changes and changes VERY quickly... you are a huge company and the money is very important I'm sure... however the overworking of your staff in order to squeeze in as many patients that you can --- is, in the process, degrading the very people that pay your bills.

With HUGE hopes that this is resolved,


Comment 1
follow up on this complaint, Yo....don't let it slide. raise a banner if necessary. This should never be tolerated and I am so glad you did not do so for the sake of convenience.

Comment 2
Although, your letter certainly pointed out the problems your encountered during your visit to a Western Dental facility, I can tell you from personal experience and from all of the other complaints I have read about Western Dental, don't expect to receive any kind of acknowledgement or apologies from Western Dental. They are a shady outfit no matter what location you happen to visit.
My husband spent 9 hours at their office in Antioch, CA. According to the law, medical and dental practitioners cannot subject their patients to more than 3-4 hours of treatment or service in a 24 hour period. My husband's dental insurance policy pays contracted providers at 100%. Western Dental is a contract provider with United Concordia (our dental insurance carrier through California Field Inronworkers Union) and they were supposed accept the insurance payment as payment in full. However, Western Dental did not properly bill our insurance company for the services they provided to my husband and as a result, they were subsequently paid less than what they calculated.
Western Dental decided that they would try to bill us for the difference. They started sending us 2-3 collection letters a month and I would call them and explain that we owed them nothing because we had 100% coverage. Then they started making collection call to our home. They would call every other day threatening to send us to collections if we didn't pay. I call the ironworker union and United Concordia to let them know what was going on. However, there wasn't much they could do. I went around and around with Western Dental corporate billing office in Orange, California, and just about everybody I spoke to down there had absolutely no knowledge about the laws governing HMO providers.
Fortunately for us, this is what I do for living . . . . medical billing. I tried and tried to explain to them that what they were doing was against the law. Balance billing and HMO patient is a highly illegal practice. I knew that most patients don't understand the complexities involved in medical billing, so I decided to conduct a rather in depth investigation into Western Dental's billing practices and I discovered that they were doing the same thing to all of ironworkers and their families throughout the State of California.
I concluded that Western Dental practices this illegal billing tactic banking on the fact, that most people don't understand the medical billing and reimbursement policies associated with their insurance carrier. The majority of patients simply trust that their medical or dental provider wouldn't bill them (the patient) unless the amount was truly the patient's responsibility. I believe that Western Dental's main source of profit comes from two aspects of their bsuiness, 1) they provide shipshod treatment to the patients, and 2) they use highly illegal billing tactics in order to coerce their patients into paying them above and beyond the contracted rate that Western Dental has agreed to accept from the patient's insurance carrier.
In order for your story to have any affect on Western Dental, please file a complaint with the following agencies; 1) the ADA (American Dental Association), 2) the California Attorney General's Office, 3) the CDA (California Dental Association), 4) California Board of Dental Examiners, and 5) the California Dept of Consumer Affairs.
If I were you, I would seek out another Dentist's opinion of the work done by Western Dental and ask them to document their opinion in writing as your situation may eventually force you to file a malpractice suit due to the poor dentistry work and pain and suffering that you have already endured and still may endure in the future. Document everything that happens to you as a result of your visit to this Western Dental facility. If your teeth are not properly repaired , you could end up suffering from a multitude of other health issues that can be caused by poor dental treatment. I cannot stress to you enough to please protect yourself by following through with my advised suggestions above, otherwise you will no recourse in case something happens in the future.
Good Luck

Comment 3


Remember the twenty Modesto dentists who were arrested several years ago, for their horrible treatment of children, the elderly, and low-income people on Medi-cal? (As far as I know, they are still waiting for trial. Justice is slow.)
These scams have been popular for many years in other states as well--especially Florida. And that is what they are--scams, just for easy money. Unqualified people have pulled entire mouthfuls of teeth that should never have been pulled. Often screaming children and the elderly were not even given pain medication. In addition,conditions were filthy.
No, these conditions are NOT normal. A dentist's office must be spotless. Otherwise, diseases spread like wildfire. Everyone must know what they are doing. Of course, you should never go back there. It is too dangerous. You do need to see a REAL dentist.
A lot of con men are "very nice". That is why they are so successful. The "wolves in sheep's clothing" play their roles well. It is important to know who is putting their fingers in your mouth!

Comment 4
Well, if you are thinking of going back to that dentist, check out the really horrible complaints against Western Dental, all over California. In the computer search spot, type: "Complaints against Western Dental" or go to www.ripoffreport.com
One person had good teeth until Western Dental worked on nine of them. Then they had nine bad teeth.
They try to treat as many people as they can and do as many procedures as they can--even if the procedures are not needed, so they can bill for them.
In addition, the FBI is investigating them for insurance fraud.
******
One complaint was from Modesto. Even though the dentist never had time to see her (after a long wait in extreme pain), Western Dental sent her a bill. When she didn't pay it, they kept adding late fees. They have a long history of complaints about fraudulent billing.
A dental chain like Western Dental in Florida was even kidnapping low-income children from their yards to pull their teeth.

more can be seen here....

Sunday, May 04, 2008

Dentists React To Small Smiles

These are posts from a Dental Message Board in reaction to Small Smiles/FORBA

1. There is a small smiles clinic close to us and we see a lot of children who have been put through the ringer there. Most times the work is sub-standard and we are re-doing what wasn't done correctly the first time around. Many of the children who are referred are great kids and just need some TSD and patience. Unfortunately, at that point they are pretty traumatized. The thing that worries us here in our clinic is the disregard for max local anesthetic dosages, etc. It's hard to believe you can papoose a 3 year old and do 4 quadrants of dentistry in one sitting, staying within the safety limits for local anesthetic. I'm all for providing needed treatment, but I'm doubtful as to how much training and supervision there are at these clinics.


2. small smiles opened in our town about six weeks ago. a good friend of mine was working as a hygienist there--she quit after two weeks. i don't know how anyone can justify treatment like that. i see kids with medicaid as does another large pedo practice in town, as do several other family dentists i know. access to care isn't an issue in my area for these kids so they can't use the "we're your child's last hope" approach.

look at the aapd guidelines. they (small smiles) aren't compliant and i don't believe they provide the standard of care offered in my area.

previous to this story, i was talking with a friend on the local peer review on how to approach this group because i was concerned about what i was hearing.


I personally LOVED This one!!!!

3. At our SSPD meeting in September AAPD president Keith Morley said to watch out for these FORBA clinics. He said they are on the way to any rural area in which they can treat low socioeconomic children for Profit.

I too see Medicaid children b/c I feel it is my way of giving back to society. The News took the absolute worst parts of the entire story and put that on TV for everyone to watch. I've been in situations in which i've had to use a papoose board while the child screamed away b/c there was no other choice. I would think any of us pedos understand exactly what was going on there. Most of what they do may not be morally right and is against the ethics of the ADA and AAPD however it doesn't break any laws. We need to all band together and keep these clinics from opening in our areas.



4. Just completed 30 years of dealing with Medicaid. It tooks it's toll on me financially (somewhat), but more emotionally and physically (which is why I stopped). The stories I have heard even for adults can be incredible, and then we get to the "access to care" issue. Who in their right mind would like to stand in line for that kind of access?

I know that there are also some incredible providers of care to this population, adults and children. But, at times, it seems that as long as the care is being "provided" by a provider, that the state powers will look the other way. An acquaintance of mine who previously worked at a one of these facilities stated that some of the dentists, at this particular facility, should not have licenses to practice.


5. If providers would treat mediciad patients as a requirement for renewal of our state granted license to make money in this limited area, access issues would greatly diminish.



6. There is one down the street from me called Vital Smiles, formally the Tooth Zone. I used to say "Who else is going to treat these kids" (I take medicaid by the way) From seeing some of the dentistry, and hearing from patients, former staff members, and a former Dr. there, a lot of those kids would be better off if they had not even gone.
7. If the Democrates get the s-chip legislation passed they will providing about 1 million more American kids with the kind of treatment that is getting blasted. S-Chip in most states is lumped into medicaid. I could care less about Dem vs Rep, but this is to make legislaotors (sp?) look good by providing insurance to these poor kids. What kind of care will be provided? Will they have access to care with this insurance?


8. small smiles clinics do not sedate or offer GA. What upsets me is not the use of the papoose per say, but it is how the clinics are run. There are several Kool Smiles clinics in the area where I practice, and they are run in a similar fashion to Small Smiles. they over treatment plan just to do pulp and crowns. I see at least 3-5 patients from their clinics , and the parent shows me the tx plans. many times it is crowns, where simple ONE surface restorations suffice. These clinics do not have a good reputation where I live.

Warning To Dental Grads Being Wooed By Corporate Dental Companies

Be careful about how you interpret the word "guaranteed” income when being wooed by a corporate dental management company such as FORBA, Heartland or Western Dental. Read this next paragraph very carefully.


A lot of these
corporate associateship contracts are set up so that you are guaranteed a certain salary based upon a specific (and sometimes unattainable) level of production. If you don't hit that level of production, you are still "paid" that salary, but you then owe the corporation the difference between the salary and what you actually produced.

So, in many cases it may seem that you will be guaranteed big dollars right out of graduation, but often that is based upon unrealistic levels of production. They spin it as "guaranteed" because you will in fact be making that money, but you will ultimately have to pay part of it back.
Go ask a few optometrists or pharmacists how much they like the corporatization of their respective professions, and you'll hear all the reasons why every effort should be made to preserve dentistry's professional autonomy.
Then you get hooked up with a Corporate Dental Company that gets nailed for mistreatment, over treatment and over billing insurances or using a blanket DEA number for prescriptions and your once stellar reputation is tarnished forever.

All those long months, days and years spent preparing yourself for a wonderful noble career is gone down the drain in less than 6 months. Not even mentioning the enormous education debt you’ve accumulated and now you won’t be able to get a job that would earn enough wages to make your loan payments let alone live, have a family or anything else. All those dreams of a fruitful life that got you through all those years of study are gone in a flash.

Lets say you don't like the procedures they teach you at their "training camps". What are you to do, you have signed a "non compete" clause in your contract. Then what are you going to do. Talk about stuck between a rock and a hard place!

There's no altruism involved in these corporations' business decisions. Corporate mills are notorious for encouraging over treatment in order to meet production goals. If you're seriously trying to come up with a minimally acceptable treatment plan for a Medicaid patient, you're looking at sealants vs. restoring every pit & fissure in the mouth, complex direct restorations instead of pressed ceramic crowns, periodontal debridement, flippers instead of implant-supported bridges, etc.

Heartland and Western shareholders are just like the ADHP proponents in that respect--they're out for their own best interests, not the public's, but they also know saying "it's for the greater good!" is a nearly impenetrable moral shield for them to hide behind.

The moral in both cases is that dentistry needs to start being proactive about figuring out solutions to the access to care problem, instead of letting other groups seize the initiative and then trying to fend them off while backpedaling.

Some companies like Kool Smiles ask employees to sign a 'restrictive covenant for 1 or more years in a radius of 5-10 miles. This mean you might be SOL if you want to work in that area.

A portion of Small Smiles /  FORBA contract says:
...for a period of 2 years following termination, you can't provide dental services for Medicaid patients within 10 mile aerial radius of the Practice Location, or Employer's practice location on the date of termination if Employer has moved its location, or the location of any of the Employer's related practices.


Add this to the $500 a day penalty for not giving them a 90 day notice and you are just screwed!  What if you had relocated!  What now?

A Discussion on Corporate Dentistry's Workings

Click Here for the sales pitch so to speak about Heartland Dental.

Includes how it works, what cuts the docs get and Employee Stock Options.

But what I find interesting is this: (The Interesting Part, is the Investment Bank involved. They were at this site for several hours last week. Houlihan Lokey Howard & Zukin.

Anyway this is a information release concerning Employee Stock Option...

EMPLOYEES ACQUIRE 38.5% OF DENTAL HEALTH RESOURCES, INC.
IN PARTIAL ESOP BUYOUT
EFFINGHAM, Ill. (January 21, 2004) – Employees of Dental Health Resources, Inc. (d/b/a Heartland Dental Care, or “Heartland”) have acquired a 38.5% ownership stake in the dental practice management company. The price of the acquisition was not disclosed.

Houlihan Lokey Howard & Zukin, an international investment bank, acted as exclusive financial advisor to Heartland. Houlihan Lokey structured the transaction, designed the ESOP security and arranged the financing for the purchase.

Heartland’s newly formed Employee Stock Ownership Trust, or ESOT, purchased convertible preferred stock representing 38.5% of the ownership of Heartland using senior credit and mezzanine funding. The transaction provided liquidity for certain selling shareholders, including Dr. Richard Workman, who founded Heartland in August 1997. The unique structure of the ESOP security and transaction provides the ESOP with an annual dividend yield while providing the company with significant future tax savings.

Workman, president and chief executive officer of Heartland, said, “Everyone is extremely excited about the ESOP and what it means for our future. The employees understand they have an opportunity to have a positive impact on the dental profession. They also realize they will create an economic interest for their knowledge by helping dental practices with management responsibilities.”

“We appreciate the dedicated professionals Houlihan Lokey Howard & Zukin assembled for the ESOP. The entire transaction team should be complimented for all their hard work and professionalism,” Workman said.

Lou Paone, managing director of Houlihan Lokey’s Washington, D.C., office said the transaction is expected to generate significant value to the employee owners in future years. “Heartland and its executive management team have a very strong employee ownership orientation,” Paone said. “The ESOP transaction and implementation marries a shareholder liquidity event with the corporate goal of aligning the employees with the future direction of the firm.” The Heartland transaction represents an innovative example of the growing trend of shareholders seeking liquidity by implementing a partial ESOP buyout structure, Paone said.

Patrick Hurst, managing director and head of Houlihan Lokey’s Healthcare Group, stated, “There haven’t been many liquidity events for shareholders of dental practice management companies in recent years. The ESOP structure is a creative alternative to selling to a financial or strategic buyer, and has the added benefit of giving the employees a real economic stake in the future success of the company.”

About Dental Health Resources, Inc.
Dental Health Resources, Inc. is a privately held company headquartered in Effingham, Ill., that provides a full range of management, administrative, and financial services to dental practices in the states of Illinois, Indiana, Iowa, Kentucky, Missouri, Ohio, and Tennessee throughout cities with populations that range from 40,000 to 500,000. By providing management services to handle the business aspects of the dental practices, the company allows dentists to use their management and business skills to be responsible for certain operations of the company and to focus primarily on delivering quality patient care. Heartland also provides capital for the development, growth, and acquisition of additional dental practices.

Houlihan Lokey Howard & Zukin, an international investment bank established in 1970, provides a wide range of services, including mergers and acquisitions, financing, financial opinions and advisory services, financial restructuring, and merchant banking. In 2003, Houlihan Lokey ranked as the No. 1 M&A advisor for transactions under $200 million and the No.4 advisor for transactions under $1 billion. The firm has been the No. 1 provider of fairness opinions for the past four years and has the largest financial restructuring practice of any investment bank in the country. The firm has approximately 600 employees in nine offices in the United States and the United Kingdom. It annually serves more than 1,000 clients ranging from closely held companies to Global 500 corporations. For more information, visit Houlihan Lokey’s Website at www.hlhz.com.

© 2004 Houlihan Lokey Howard & Zukin. All rights reserved.
Unauthorized duplication is prohibited.

Dr. Alireza Nazeri: Suspended Washington Dentist Practicing In Palm Springs


4-29-2008


Read the Full Report here on Dr. Alireza "Allen"' Yekta Nazeri, WA license # DE00006673.

What blows me away in this is that it too 32 complaints before his licenses were suspended!

Here is the final order:

California: In April 2005 the Dental Commission placed the license of Alireza Y. Nazeri, a dentist licensed in Washington (DE00006673), on a stayed suspension for five years, but he may not practice in Washington until the commission authorizes.

Nazeri failed to comply with the terms and conditions of a prior order.

Dr. Nazeri was to undergo psych evaluation.

Here is Dr. Nazeri's now practice Cornerstone Dentistry in Palm Desert, CA.

Be sure to check the "In The Media" link for a nice picture.

Dr. Alireza (Allen) Y. Nazeri is another graduate of Creighton University, same as the DeRose's. See Dr. Nazeri's bio here, and is a member of the Iranian American Dental Association.

I guess Dr. Nazeri is still working, here is where he taught a class in December 2007 on:

Secrets behind your patients saying “YES” to an Elective and Comprehensive treatment revealed!!!

You just gotta check this one out! He shows you how to get more fee for service from dental patients.

This man should not be practicing dentistry anywhere yet has a posh clinic in Palm Desert. What is wrong with this dental system anyway! Is anyone at all watching!!!!!

Anyone reading this board what to take a guess where Dr. Nazeri went to dental school?

Creighton of course! What the living hell are they teaching these dentists over there anyway?

Heartland Dental Management Dentists Accused Of DEA Number Sharing

From Federal Compliant File 4-2008

US vs Heartland Dental Care, Inc.

Heartland Dental Care, Inc. referred to as "Heartland" is a
Delaware corporation in good standing located at 1200 Network Centre Dr., Effingham, Illinois.

Heartland manages dental practices throughout the state of Illinois and elsewhere. Heartland
Dental Care, Inc., which was not incorporated until 2006, is the successor entity to Dental Health
Resources, LLC, Dental Health Resources, Inc. and Heartland Dental Development, Inc.
(collectively "DHR entities"). The DHR entities managed the dental practices, entities, dentists
and employees whose conduct is described below.

Richard E. Workman, D.M.D. is the President and Chief Executive Officer for Heartland.

In the Complaint dentists employees by Heartland at various locations used DEA numbers of other registered dentists to write prescriptions regulated medications.

DEA Inspector reviewed conduct between 2003 and 2007 and found numerous instances of misuse of DEA numbers.

Heartland employed newly graduated dentist who were not yet registered and issued a DEA number for dispensing prescription of controlled substances. Therefore in order to conduct business these dentists used DEA numbers of established dentists.

Heartland Dental was aware and facilitated in this procedure.

Wow, I wonder if this goes on at other Dental Management Companies as well, namely FORBA!

If any of you employees out there know of fraud and corruption at FORBA you could well end up like the woman in Illinois who reported them under the false claims act as a Whistle Blower entitling her to a portion of the fine/settlement. As well she won over $300K for wrongful termination.

I've put links on the side bar regarding the False Claims Act Laws and Whistle Blower Protection.

New York Leave State Vulnerable to Corportate Dental Abuse

§ 6604. Requirements  for  a  license  as  a dentist. To qualify for a
license as a dentist, an applicant shall fulfill the following
requirements:

(1) Application: file an application with the department;
(2) Education: have received an education, including a doctoral degree
in dentistry, in accordance with the commissioner's regulations;
(3) Experience: have experience satisfactory to the board and in
accordance with the commissioner's regulations, provided that such
experience shall consist of satisfactory completion of a
clinically-based postdoctoral general practice or specialty dental
residency program, of at least one year's duration, in a hospital or
dental facility accredited for teaching purposes by a national
accrediting body approved by the department, provided, further
that any such residency program shall include a formal out come
assessment evaluation of the resident's competence to practice
dentistry acceptable to the department;
(4) Examination: pass a written examination satisfactory to the board
and in accordance with the commissioner's regulations;
(5) Age: be at least twenty-one years of age;
(6) Citizenship or immigration status: be a United States citizen or
an alien lawfully admitted for permanent residence in the United States;
provided, however, that the board of regents may grant a three year
waiver for an alien to practice in an area which has been designated a
federal dental health professions shortage area, except that the board
of regents may grant an additional extension not to exceed six years to
an alien to enable him or her to secure citizenship or permanent
resident status, provided such status is being actively pursued;
(7) Character: be of good moral character as determined by the
department; and
(8) Fees: pay a fee of two hundred twenty dollars to the department
for admission to a department conducted examination and for an initial
license, a fee of one hundred fifteen dollars for each reexamination, a
fee of one hundred thirty-five dollars for an initial license for
persons not requiring admission to a department conducted
examination,and a fee of two hundred ten dollars for each triennial
registration
period.

Dr. George C. Brain: Another Terrorist Dentist In Tacoma Washington

The state Department of Health has opened a new investigation into a Tacoma dentist accused of mistreating young patients.That action comes on the heels of an exclusive KIRO Team 7 Investigation into Dr. George C. Brain.

Children have repeatedly complained over the years that Brain choked, shoved, assaulted or grabbed them by the throat.Now, Investigative Reporter Chris Halsne pins down the Dental Board about its handling of Dr. Brain.Dr. Brain's resume includes nine police reports from kids who claim to have been assaulted during dental work.

Those resulted in a charge of assault on a child, but no criminal convictions.However, in addition, for the first time, we dig inside Dr. Brain's licensing file to discover more accusations of assaultive or threatening behavior.Pediatric dentist Dr. George Brain has been under scrutiny for professional misconduct for years.

Records at the Dental Quality Assurance Commission show seven complaints of assault, abuse or verbal threats towards children.One led to disciplinary action. A 2006 case shows a girl complained Dr. Brain choked her and pulled some teeth without permission. The board assigned Dr. Brain to a "monitoring" program and required an "anger management evaluation."Laurie Jinkins, an Assistant Secretary at the state Department of Health, oversees dental licensing complaints.She tells KIRO Team 7 Investigators, “That would not be a typical number of complaints. That is a high number and it is something that causes us concern.”Jinkins defends the state’s disciplinary process, saying Dr. Brain has been on their radar and they’re watching him.“We're concerned when any patient has a bad experience with their health care provider, but especially with kids or vulnerable people.

That makes us especially concerned because kids can't protect themselves.”Five-year-old Cameron Laducer and his sister, Courtney, are the latest kids to accuse Dr. George Brain of hurting them. A complaint, on file with the dental board this week, alleges Dr. Brain overmedicated Courtney, yanked a tooth, and filled a cavity in another tooth without parental permission.It also accuses Dr. Brain of creating scratches on Cameron's face and causing a grossly infected lip.The children’s mother, Brooke Laducer, tells KIRO Team 7 Investigative Reporter Chris Halsne, “I'm very, very angry with the State of Washington. Number one, I want to know why this man still holds a license. I want to know why he can still work on children. “Laurie Jinkins says she can't talk about the Lacuder's new complaint; it's under active investigation.

She did, however, address another of our questions.We discovered Dr. Brain made around $1.5 million last year from the state in return for treating low-income children and their families.Halsne: “Does a patient who doesn't have any money, who has to use a state welfare voucher to get that work done -- should they receive any lesser care than someone with premium insurance?”Jinkins: “Everyone in this state, no matter how rich or how poor they are, whether they have insurance or don't have insurance, they are entitled to the same level of care, the same quality of care in this state."

Dr. Brain has chosen to remain silent and is not speaking with us regarding our investigation.Others are not so quiet.Dozens of people have called and e-mailed Tuesday, wanting to tell KIRO Team 7 Investigators about their treatment inside Dr. Brain's office.If you have any concerns about his conduct or the conduct of any other dentist in Washington, the state Health Department wants to hear from you.

Click Here for Video Report, Interviews with patients, police reports and more.

Saturday, May 03, 2008

Should Michael DeRose Ever Been Licensed In North Carolina?

Should Michael DeRose or any corporate dentist group actually have access to treating patients under North Carolina Law is the question here. I say unless that dentist is licensed and actively practices in North Carolina, they should have their licenses revoked! But of course this is where dentists like Dr. Raf Rivera and Dr. Tish Ballance come in isn't it. They become the "local" actively practicing dentists.

If you "google" those in charge of Small Smiles, Kool Smiles, Ocean Dental and others, they have offices as well as licenses in various states across the US. But you and I both know they don't "actively" participate.

For instance, Dr. Adolph Padula, Mike DeRose's uncle) with FROBA Small Smiles says he can be seen in New York, Massachusetts, Colorado and Ohio. In the MassHealth Directory it says Dr. Padula is accepting new patients. I see this over and over. Now grant you they are a bit careful. But in the instance of getting on lists of providers not so much. The names crop up in state after state.

I understand that each state is different, but most require them to "actively" practice dentistry and it's that way for a reason. This is where Tennessee got Dr. William Mueller a few years back that was reduced to an advertising sanction. They get licensed and advertise in states where they have a licenses, but fail to "actively" practice dentistry.

Let's Look At North Carolina:

North Carolina General Statutes:

§ 90-36. Licensing practitioners of other states.

(a)The North Carolina State Board of Dental Examiners may issue a license by credentials to an applicant who has been licensed to practice dentistry in any state or territory of the United States if the applicant produces satisfactory evidence to the Board that the applicant has the required education, training, and qualifications, is in good standing with the licensing jurisdiction, has passed satisfactory examinations of proficiency in the knowledge and practice of dentistry as determined by the Board, and meets all other requirements of this section and rules adopted by the Board. The Board may conduct examinations and interviews to test the qualifications of the applicant and may require additional information that would affect the applicant's ability to render competent dental care. The Board may, in its discretion, refuse to issue a license by credentials to an applicant who the Board determines is unfit to practice dentistry.

(b) The applicant for licensure by credentials shall be of good moral character and shall have graduated from and have a DDS or DMD degree from a program of dentistry in a school or college accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board.

(c) The applicant must meet all of the following conditions:

(1) Has been actively practicing dentistry, as defined in G.S. 90-29(b)(1) through (b)(9), for a minimum of five years immediately preceding the date of application.

G.S. 90-29 (b)(1) thru (b)(9)

(1) Diagnoses, treats, operates, or prescribes for any disease, disorder, pain, deformity, injury, deficiency, defect, or other physical condition of the human teeth, gums, alveolar process, jaws, maxilla, mandible, or adjacent tissues or structures of the oral cavity;

(2) Removes stains, accretions or deposits from the human teeth;

(3) Extracts a human tooth or teeth;

(4) Performs any phase of any operation relative or incident to the replacement or restoration of all or a part of a human tooth or teeth with any artificial substance, material or device;

(5) Corrects the malposition or malformation of the human teeth;

(6) Administers an anesthetic of any kind in the treatment of dental or oral diseases or physical conditions, or in preparation for or incident to any operation within the oral cavity; provided, however, that this subsection shall not apply to a lawfully qualified nurse anesthetist who administers such anesthetic under the supervision and direction of a licensed dentist or physician;

(6a) Expired pursuant to Session Laws 1991, c. 678, s. 2.

(7) Takes or makes an impression of the human teeth, gums or jaws;

(8) Makes, builds, constructs, furnishes, processes, reproduces, repairs, adjusts, supplies or professionally places in the human mouth any prosthetic denture, bridge, appliance, corrective device, or other structure designed or constructed as a substitute for a natural human tooth or teeth or as an aid in the treatment of the malposition or malformation of a tooth or teeth, except to the extent the same may lawfully be performed in accordance with the provisions of G.S. 90‑29.1 and 90‑29.2;

(9) Uses a Roentgen or X‑ray machine or device for dental treatment or diagnostic purposes, or gives interpretations or readings of dental Roentgenograms or X rays;

(2) Has not been the subject of final or pending disciplinary action in the military, in any state or territory in which the applicant is or has ever been licensed to practice dentistry, or in any state or territory in which the applicant has held any other professional license.

(3) Presents evidence that the applicant has no felony convictions and that the applicant has no other criminal convictions that would affect the applicant's ability to render competent dental care.

(4) Has not failed an examination conducted by the North Carolina State Board of Dental Examiners.

(d) The applicant for licensure by credentials shall submit an application to the North Carolina State Board of Dental Examiners, the form of which shall be determined by the Board, pay the fee required by G.S. 90-39, successfully complete examinations in Jurisprudence and Sterilization and Infection Control, and meet the criteria or requirements established by the Board.

(e) The holder of a license issued under this section shall establish a practice location and actively practice dentistry, as defined in G.S. 90-29(b)(1) through (b)(9), in North Carolina within one year from the date the license is issued. The license issued under this section shall be void upon a finding by the Board that the licensee fails to limit the licensee's practice to North Carolina or that the licensee no longer actively practices dentistry in North Carolina. (1935, c. 66, s. 9; 1971, c. 755, s. 7; 1981, c. 751, s. 6; 2002-37, s. 2.)

Does anyone reading this blog think that Michael DeRose, living in his Pueblo Colorado 3.4 million dollar recording breaking home EVER "actively" practice dentistry in North Carolina as defined?

Michael DeRose has sanctions in other states, namely Colorado for one.

He would have had to one of the following to be considered actively practicing dentistry:

(1) Diagnoses, treats, operates, or prescribes for any disease, disorder, pain, deformity, injury, deficiency, defect, or other physical condition of the human teeth, gums, alveolar process, jaws, maxilla, mandible, or adjacent tissues or structures of the oral cavity;

(2) Removes stains, accretions or deposits from the human teeth;

(3) Extracts a human tooth or teeth;

(4) Performs any phase of any operation relative or incident to the replacement or restoration of all or a part of a human tooth or teeth with any artificial substance, material or device;

(5) Corrects the malposition or malformation of the human teeth;

(6) Administers an anesthetic of any kind in the treatment of dental or oral diseases or physical conditions, or in preparation for or incident to any operation within the oral cavity; provided, however, that this subsection shall not apply to a lawfully qualified nurse anesthetist who administers such anesthetic under the supervision and direction of a licensed dentist or physician;

(6a) Expired pursuant to Session Laws 1991, c. 678, s. 2.

(7) Takes or makes an impression of the human teeth, gums or jaws;

(8) Makes, builds, constructs, furnishes, processes, reproduces, repairs, adjusts, supplies or professionally places in the human mouth any prosthetic denture, bridge, appliance, corrective device, or other structure designed or constructed as a substitute for a natural human tooth or teeth or as an aid in the treatment of the malposition or malformation of a tooth or teeth, except to the extent the same may lawfully be performed in accordance with the provisions of G.S. 90‑29.1 and 90‑29.2;

(9) Uses a Roentgen or X‑ray machine or device for dental treatment or diagnostic purposes, or gives interpretations or readings of dental Roentgenograms or X rays;