Tuesday, March 17, 2009

Kansas TV Station Looks Into Small Smiles

Families Concerned About Small Smiles

Posted: March 17, 2009 03:40 PM

Updated: March 17, 2009 09:30 PM

Jason and Naomi Pinkston called FactFinder Investigators shortly after taking their four-year-old daughter, Aerial, to the dentist. They say they knew right away something wasn't right.

"I feel they took advantage of my daughter to make a profit," says Naomi.

Jason says the family did research shortly after their experience at the clinic.

"All you have to do is Google these guys to get page after page of horror stories. It felt like a nightmare we couldn't wake up from," says Jason.

That nightmare, as Jason describes it, is the work Small Smiles performed on Aerial. The family showed us before and after pictures of Aerial's teeth. Her baby teeth were showing signs of decay so Small Smiles ground them down and put crowns on them. But the Pinkstons say their problems began before any work was performed.

"She didn't explain anything to me about why it would be important to Aerial to have crowns-whether we didn't do it what would happen or what a crown was. Absolutely nothing," says Naomi.

We don't know if the work was necessary; it's too late to get a second opinion because her teeth are gone. We can tell you four of Aerials front teeth that were crowned by Small Smiles will have to be pulled by another dentist.

We wanted to talk to Small Smiles about Aerial's dental work, but instead were referred to a company in Washington, D.C. Spokesperson Don Meyer tells us the clinic thinks Aerial's treatment plan was appropriate, but the execution was less than ideal. He says because of what happened, dentists in the Wichita clinic will seek continuing education.

"What we're finding is that some of our dentists may require some extra training on what's called a ‘New Smile Crown'," says Meyer.

Although Small Smiles markets exclusively to children, we were told none of the dentists at the clinic have pediatric qualifications. They are trained only in general dentistry.

We talked to pediatric dentists in the Wichita area. All of them told us many of their patients come from Small Smiles. Patients like Shelbi Meisch's daughter Amaya.

"She's terrified to see the dentist, still. Every time we go she's scared to go in," says Shelbi.

Like the Pinkstons, Shelbi doesn't feel her options were explained and Small Smiles ended up pulling six of Amaya's teeth.

"No they didn't tell me they were going to be pulling all those teeth. I was under the impression they were going to crown two back teeth and pull the front teeth," says Amaya.

Another dentist had to perform corrective work Amaya's case.

Then there is Stacy Luthy and daughter Emma. Stacy contacted us after learning we were working on the story.

"They informed me that they had a harness they put the kids in that restrains them. They made it sound routine and no big deal."

Stacy wasn't allowed to be in the room with her daughter when they went to Small Smiles about two years ago.

"About 20 or 30 minutes later they came out and said she had been throwing up. They brought her to me. She had been screaming. She was horrified. She was in tears," says Stacy.

Like Aerial and Amaya, Emma has also had corrective work performed. The teeth Small Smiles crowned fell out, leaving her with nothing until her permanent teeth come in.

The parents say all three girls now have to be sedated to even visit the dentist.

"She'll never not be afraid of a dentist, which is alone is horrible because it's such an important thing to do," says Naomi Pinkston.

That's why the Pinkstons came to us. To encourage other parents to ask the questions they didn't ask.

More Company Response:

Forba, the company that manages Small Smiles, tells us many changes were made in late 2007. They include some of the following:

  • Parents are now allowed back with their children during visits. Small Smiles made the change after receiving complaints from parents.
  • It conducted about 12,000 surveys seeking parental feedback.
  • Working to better communicate with parents.
  • Dentists have been retrained on the use of protective restraint
  • Created a toll-free number for parents to call with concerns or complaints (1-877-302-KIDS)
  • Kansas law requires dentists' offices to be locally owned. This is the company's response to corporate ownership concerns.

It is not uncommon for doctors and dentists to hire or outsource various professional and specialized services, including advertising, computer technical support, legal advice, and even human resource specialists to assist them in managing their practices. For example, the Kansas Medical Society created a practice management firm to provide a broad range of office management services to physician practices around the state. Such services are provided under a management services agreement, include a variety of services and are done for a negotiated fee, much like our agreement with Dr. Reza.


Click here for the transcript of the live chat that took place after the segment aired.


________________________________________

This blogger's Comments:

I don't care what kind of crap they say, Dr. Mohammad Reza Akbar doesn't own this clinic. At the Kansas Secretary of State's Office it says the mailing address is:

Linda Zoller
618 Church Street, Suit 520
Nashville, TN 37219
(FORBA Holding and FORBA Services Address, Linda Zoller is just the VP of the legal department and does most of the state business filings.

I don't even think Dr. Reza Akbar lives in Kansas but I could be wrong, he didn't used to.

As you noticed no one at FORBA would speak on camera, heck they don't speak off camera. They only send their PR guy, Don Meyer to appear, or write responses or start a blog to defend and promote the company. You would think Dr. Reza would want to defend his own clinic wouldn't you?

Don Meyer says a lot of changes took place in 2007. Well, evidently not near enough since I didn't start this until early 2008 and I've heard these horror stories for well over a year now, and they still keep coming in. All of their talk is nothing but Hogwash and they think people are actually going to be gullible to believe it.

********************************************************************************

Here is just one comment from the KWCH TV Website: (go to the bottom of the page and click on 'see all comments')


Whistleblower:

Thursday, March 19, 2009

To Jason, you are welcome and yes I am employed at Small Smiles. The guest brought up some good points...why am I still there? Partly because I do know what goes on and even if I can only save a couple of kids from being traumatized by the procedures and roughness that and unnecessary work I have done a little to stop some of it.

I know I can't stop it all but anything helps. Yes I will be out of a job but there will be a lot of kids that won't be put through this there. As for the dentist in Colorado....yes it is a different state but Small Smiles is nationwide and all of the training is done in Pueblo, CO for the dentists so you see...they have one way of training and we have had a number of dentists that were just as bad, maybe not taking drugs but doing terrible work or pulling permanent teeth when it should have been the baby tooth, or numbing the right side and then working on the left side and ignoring the child's screams of pain.

I know they have the same sub standard type of dentists across the nation. Maybe not ALL of them but a good portion of them are very substandard. The good dentists that we have had didn't last long. They left because they refused to work like that and didn't want to jeopardize their licenses. Trust me...when I first started working there I couldn't believe this type of care was actually going on in America. Maybe I will loose this battle and they will continue to operate but at least I tried and I know I have saved a few kids from the horror and pain along with the parents.


********************************************************************************
UPDATE:


By Michael Schwanke (WICHITA, Kan)
investigators@kwch.com
316-831-6166

Update:

STATEMENT FROM SMALL SMILES DENTAL CLINIC OF WICHITA

Every year we see thousands of children who receive compassionate, high-quality dental care at our dental center. Through our parent surveys, comment line and direct interaction with caregivers, Wichita families regularly express high levels of satisfaction with our care.

However, based on the story aired by Channel 12, an internal review of standards, quality and compliance has been initiated at the Small Smiles Dental Clinic of Wichita.

We take seriously any parent who expresses concern with their child's care, and we are always looking for ways to improve. We strongly urge any parent who has concerns to contact our parent hotline at 1-877-302-KIDS.

Kansas Dental Board is asking that anyone with a complaint regarding Small Smiles contact their office.
You can file an offical complaint at
http://www.kansas.gov/kdb/ or call 785-296-6400.





________________________________________________
This blogger's comment:

1. The key word in that statement is the word "our". If Dr. Akbar owned that clinic wouldn't the term be "my" but no, they once again FORBA admits to owning these clinics.

2. I've heard this same statement over and over for 2 years! Why do you think that hotline number was set up in the first place?

3. The Kansas Dental Board has been alerted on several occasions about Small Smiles and their tactics and haven't done a darn thing so far. But I highly suggest you give it a go anyway.

4. I like to hear from those patients who were actually treated by Dr. Mohommad Reza Akbar himself.

Monday, March 09, 2009

Man Died After Having Wisdom Teeth Pulled; New Jersey Jury Awards $11 Million for Dental Malpractice

 

March 09, 2009 10:06 PM

In the largest oral surgery malpractice verdict in New Jersey history so far, a jury awarded $10.2 million this week to the family of 21-year-old Francis Keller of Woodbridge, who died from suffocation after having his wisdom teeth removed by oral surgeon Dr. George Flugrad, of Perth Amboy.

Because Keller had a genetic immune disorder which caused severe swelling in reaction to trauma, he should not have been a candidate for dental or any other surgery. The morning after his tooth extractions, he began to have trouble breathing, and suffered from throat swelling that ultimately led to suffocation and death.

The Middlesex County jury found that Dr. Flugrad committed malpractice when he extracted the wisdom teeth in full knowledge of Keller’s genetic condition.

Friday, March 06, 2009

Colorado Springs Gazette Mentions 20/20 Probe

Colorado Springs Gazette's reveals 20/20's probe into Small Smiles.

 

Small Smiles dentistry focus of ‘20/20′ probe
March 5th, 2009, 2:02 pm by Brian Newsome

Small Smiles Dental Centers, a national chain with offices in Colorado Springs, Denver and Pueblo,  will be featured Friday in a “20/20″ report about questionable practices. Small Smiles, which serves mostly children on Medicaid, has come under fire in various media stories for restraining kids, not allowing parents to be present with them, and doing unnecessary procedures to get Medicaid reimbursements Here is a YouTube clip from an ABC News investigation in the D.C. area.

A spokeswoman for “20/20″ confirmed the report will air Friday at 8 p.m. MST. Correspondent Deborah Roberts reported from Pueblo, according to 20/20 media relations publicist Alyssa Z. Apple, but Colorado Springs is not specifically mentioned.

Wednesday, March 04, 2009

I found the following over at "American Thinker".

By Brian Riley:

When President Obama recently nominated Kansas governor and universal healthcare advocate Kathleen Sebelius to be to the country's Secretary of Health and Human Services (HHS), the president of America's Health Insurance Plans (AHIP) called it "a very smart choice. She has a good intellect, a big heart and tremendous expertise." AHIP and its predecessor, the Health Insurance Association of America, have a track record of financial support for Gov. Sebelius dating back to the time she served as Kansas Insurance Commissioner.

Of course, the health insurance industry also supported President Obama's first choice, Sen. Tom Daschle. Daschle's financial backers included AHIP, which paid Daschle $40,000 for two speeches, and health-insurance giant United Health Care, which paid him $5,000 for "advice."

Many people criticized Daschle for taking money from the insurance industry. Few people asked the more obvious question: What were insurance companies doing paying thousands of dollars to someone who devoted his life to policies that could put them all out of business?

Daschle's book Critical: What We Can Do About the Health Care Crisis praises universal, single-payer healthcare as a worthy goal. However, he concludes that it would be politically problematic to implement such a system in the United States due to the opposition of special interest groups like the insurance industry.

Here is how AHIP, the health insurance industry's top trade association, responded to the nomination of someone who views the very existence of insurance companies as an obstacle to reform:

"Senator Daschle is exceptionally well qualified to bring people together in support of universal coverage, cost-containment, and improved quality."

The industry's philosophy -- not to oppose policies that would harm insurance companies and their customers; not to simply acquiesce to ridiculous demands; but to enthusiastically embrace changes designed to reduce the ability of average Americans to buy health insurance -- was on display during the recent expansion of the State Children's Health Insurance Program (SCHIP, commonly pronounced S-CHIP), the federal program designed to provide healthcare to children.

In the past, SCHIP benefits typically were limited to families earning up to 200 percent of poverty level. The legislation recently passed by Congress raises the cap to 300 percent of poverty level and allows states to raise the cap even higher, subject to lower federal subsidies for those additional benefits.

To qualify for SCHIP benefits, the government requires families to first drop their individual health insurance entirely.

If families do not have an individual policy but get their coverage through their employer, they may be allowed to keep their group coverage in some cases. States may offer this option if the employer pays least 40 percent of the cost, as long as the policies do not allow families to set up a health savings account to pay for their medical expenses.

As a result of provisions like these, many kids who enroll in SCHIP in the future will not come from the ranks of the uninsured, but from families that drop their private coverage in order to receive "free" government care. According to the Congressional Budget Office, even before these changes it already was the case that for every 100 children who qualified for SCHIP, 25 to 50 dropped their private insurance.

Imagine for a moment that you are the chief lobbyist for U.S. health insurance industry, and Congress is considering a law that would give government healthcare benefits to people who can afford to pay for their own insurance. Further imagine that Congress would require people who already have health insurance to drop that coverage in order to qualify for government aid. What would your response be?

Here is the actual response if the insurance industry, provided by AHIP:

"This vital legislation provides health security for millions of children in working families and builds momentum for comprehensive health care reform. Expanding coverage for kids is a big first step toward ensuring that all Americans have affordable, quality health care."

Some foreshadowing of the insurance industry's apparent death wish came during the U.S. Presidential campaign. Sen. John McCain proposed giving families $5000 each to buy their own health insurance, while Sen. Obama proposed giving everyone the option of a "new public plan" instead of private health insurance. My review of campaign donation data indicates that employees of the nation's biggest health insurers -- Aetna, Blue Cross, Cigna, Humana, United HealthCare, and Wellpoint -- voted with their dollars, giving over twice as much to Obama as to McCain.

In Ayn Rand's book Atlas Shrugged, industrialist Hank Reardon is stabbed in the back by his "man in Washington," Wesley Mouch. In the novel, Reardon is a relatively innocent victim of the man hired to protect his interests from Washington predators.

In the real world, the insurance industry is no innocent victim. For example, to head its Washington operations, the industry chose someone whose experience came from working for the AFL-CIO and, I am not making this up, the Committee for National Health Insurance, an organization formed by labor unions to lobby for "a truly radical overhaul of the health care system" with the federal government as the nation's only health insurance carrier.

I wonder how that job interview went:

Question: "Tell us a little about your experience."

Answer: "I've been working to put you all out of business."

Reply: "Great! When can you start?"

I personally know someone who recently was sent out of her local welfare office in tears, because an overwhelmed government bureaucrat mistakenly told her there was no state coverage available for her child's leukemia.

I know of a child who was hospitalized because her parents were not given government assistance to buy insurance, but instead were forced to use the local Medicaid-funded clinic where their daughter was misdiagnosed.

I have read stories in my local newspaper about children who are strapped to "papoose boards" like tiny Hannibal Lecters in order to get their teeth examined. Why? Because instead of providing financial assistance to low-income families to make dental insurance more affordable, the government instead forces them to go to Medicaid-financed dentists.

These horror stories are what we all have to look forward to as elected officials, aided and abetted by insurance industry lobbyists, gradually replace private health insurance with government-run healthcare.

Bryan Riley was the Republican candidate for Kansas Insurance commissioner in 1998, losing to incumbent Kathleen Sebelius.


I just wish that money was allocated to increase reimbursement rates to our private dentists. This would surely shut down these dental mills. Hit them in the pocketbook, right?

I encourage each of you to contact your state Legislators and Heath and Human Services Department and voice your opinion about increasing the reimbursement rates.





Thursday, February 26, 2009

I was doing my weekly searches of various 'terms', one was 'medicaid fraud'.  One the second page or two of the results I ran across something at a very unusual website called jihadwatch.org.

Here are a couple of snippets from a comment I found there:

 

"Their attitude toward governments is strictly adversarial. Every man is expected to get away with as much as he can and trust extends to one's family and clan alone. When they come to the U.S. Muslim doctors start medicaid fraud mills and even those who run small groceries frequently launder money, deal in fake cigarette tax paper, etc etc. Parasites on an 'infidel' state. These aren't the 'bad apples'. These are the 'good Muslims'."

 

 

As for the behavior of Muslims in the West, why should they not fiddle the system of the Infidels? After all, it is only just, only right, that they take whatever they can from the Infidels, and cheating the government of an Infidel nation-state is not cheating, from a Muslim point of view, at all - nor is cheating Christians, Jews, Hindus and others who, in effect, are living on borrowed time -- until that moment when Muslims become stronger, and more numerous, and can impose their will, as they have, in the Muslim view, not merely a right, but a divine right, to do so.

Not every single Muslim, obviously, feels this way. But opinion polls and information of all kinds that goes far beyond the merely anecdotal evidence (though that anecdotal evidence is not to be dismissed), and simple common sense about what Islam teaches its Believers to believe, and which a great many of them clearly do believe, tells us that many of them -- a great many -- do indeed think this way, and act, when they can get away with it, upon it.

Tuesday, February 24, 2009

Dr. Maziar Izadi Leaving FORBA's Albany Access Dentistry?

It's been reported to me that Dr. Maziar Izadi of Small Smiles Albany, New York fame is leaving the practice. I don't know how true this is, but it came from a pretty solid source. 

If you remember he was the 'lead' dentist when this clinic was called Small Smiles, then the bad press hit the clinic with a series of reports from Steve Flamisch.

FORBA then changed the name of the clinic to Albany Access Dentistry, then tried to sell the public and New York's Medicaid System that it was under new ownership and the new owner was Dr. Izadi and FORBA was no longer involved. We know this not the be the case now, don't we.

Wonder who will be the lead dentist now, clearing throat, I mean 'owner' of Albany Access Dentistry.

Wonder if Dr. Izadi is getting ready to skip the country?

update:
He went to work at another clinic who was notified who he was, he was fired.  He then landed at Allcare or Aspen, I forget.

Tuesday, February 17, 2009

Emails Say FORBA/Small Smile's Revenue Down Due Since Having To Alter The Way They Treat Patients After Investigations

Jim Scarantino updates us on his look into New Mexico's Investment into FORBA/Small Smiles at the Rio Grand Foundation Website:

Newsflash: The State Investment Council doesn’t know what it’s doing with our money.

In the Rio Grande Foundation’s last report on the State Investment Council (SIC), we asked whether the SIC was really on top of what was being done with our money. We took a close look at one of the SIC’s smallest investments, a $550,000 acquisition of equity in a low-income dental chain called Small Smiles. We chose to investigate this investment for two reasons: (1) it would not be too large to overwhelm us; and (2) if we could get a handle on Small Smiles, then one would think the SIC would also have a full grasp of the facts surrounding this modest investment.

We were able to gather a full range of information about Small Smiles. That information revealed its foreign corporate ownership as well as a raft of scandals about the way Small Smiles mistreats children and bills Medicaid for its services. All of that information came from sources other than the SIC. The SIC could not answer even the question as to how much of the state’s money was invested in Small Smiles. We ended up knowing more about this investment than the SIC itself.

Our suspicions that the SIC does not know what is being done with our money were confirmed in a review of documents recently produced under a Public Records Act inspection.

In late November 2008, we filed a request to inspect every document—every memorandum, e-mail, report and letter—containing any information about Small Smiles. We were able to inspect the documents at the SIC’s offices on Wednesday, January 7, 2009.

For an investment of over half a million dollars that has been its portfolio for nearly two years, the SIC had only 73 pages in its files. Many of those pages were duplicates of the same e-mails. Many were simply lists of companies. Many of the pages were merely cover letters containing no substantive information. Close to half of the pages produced did not mention Small Smiles at all.

Some of the pages simply mentioned the words “Small Smiles” once without providing any information about the company, its finances, or operations. For instance, a list of all the New Mexico companies in which the SIC was invested would merely name Small Smiles, but would say nothing about the company’s affairs. Numerous versions of documents of that nature were among those turned over by the SIC.

The e-mail correspondence conclusively shows that the SIC has been negligent in monitoring this investment. A little over a week after the Rio Grande Foundation began asking questions, an e-mail dated December 5, 2008, was sent from Brian Birk, the managing partner of Sun Mountain Capital, to Bruce Duty, a partner in Red River Ventures. Sun Mountain Capital is the investment firm in Santa Fe that manages the SIC’s New Mexico’s private equity investment program. Red River Ventures is the venture capital firm that made the investment in Small Smiles in 2007.

“Hi, Bruce,” Birk writes, “it’s been a while since we’ve touched base….I was over at the SIC talking to Greg K [Greg Kulka, the SIC’s Director of Private Equity and ETI Investments] and somehow the topic of Small Smiles came up. As I recall, RR [Red River Ventures] has an investment in the company. Was that in the parent company, a subsidiary, or ??? If you could provide a little color that would be appreciated. Also, Greg and I could not remember the last time we received a quarterly report from Red River. Could you e-mail us your latest, and are you current in your reporting?” [Emphasis added]

Several things stand out. First, the SIC and its venture capital manager reveal they did not know where the money for the Small Smiles investment had gone, into “the parent company, a subsidiary, or ???” Yet, in its 2007 year-end report, the SIC touted Small Smiles as one of the “New Mexico companies” in which it had proudly invested taxpayer money. From all the records reviewed, including years of meeting minutes, this is the first time the SIC ever asked where our money went.

Second, the e-mail proves that the SIC and its venture capital manager were not staying on top of this investment. They “could not remember the last time” they had received a quarterly report from Red River. The SIC’s ignorance was so bad it had to ask Red River whether it was current in its reporting, instead of being able to ascertain that information from the SIC’s own files.

Bruce Duty of Red River Ventures answered two days later, December 8, 2008, at 3:06 p.m. All of the deletions were made by the SIC before disclosing the correspondence to us.

“Brian and Greg:

Yes, it has been a while since we’ve spoken.

Unfortunately, every company in Red River’s portfolio is being impacted to some degree by ‘the storm.’ Those suffering the highest stress include Small Smiles and [deleted]. For both of these companies, the story is too much acquisition debt and too little EBITDA [earnings before interest, taxes, depreciation and amortization]. [Deleted] and [deleted] have never been profitable and will need to raise cash to avoid failure….

The situation at Small Smiles is [deleted]. The company has endured a year of adverse publicity that triggered investigations by the DOJ and 16 state AGs. Because of the intense scrutiny, the dentists across the system have significantly reduced the way they practice, resulting in the revenue per patient visit falling from over [deleted] a year ago to [deleted] currently.

This the first time in nearly two years of holding an investment in Small Smiles that the SIC was informed of the scandals entangling company’s operations. A review of the minutes of the SIC’s meetings and the meetings of the New Mexico Private Equity Investment Advisory Council show that Small Smiles was never once mentioned or discussed by the people who supervise investments of state money.

This e-mail sheds light on the problems with Small Smiles’ billing practices. The company is being investigated for overcharging and performing unnecessary procedures. It faces allegations that its dentists worked under billing quotas, and did unnecessary work to hit their numbers. Small Smiles has been suspended from some state Medicaid and private insurance programs because of its unethical billing practices. The fact that Small Smiles dentists “have significantly reduced the way they practice, resulting in revenue per patient falling” lends credence to the allegations against Small Smiles. It indicates that Small Smiles dentists were providing treatment based not on what was medically necessary, but based upon revenue targets.

This time Greg Kulka, the SIC’s Director of Private Equity and ETI Investments, sent the follow-up e-mail to Red River. About one hour after receiving Bruce Duty’s first detailed report on Small Smiles he writes:

“Bruce, My main question is about Small Smiles. I know they have offices here in New Mexico. Are they headquartered here? In other words, are they considered a New Mexico company? Please let me know. Thanks.

Remember: the SIC’s 2007 annual report boasted of its investment in Small Smiles, identified as “a New Mexico company.”

Bruce Duty of Red River wrote back within minutes:

“Greg, the corporate offices of Small Smiles are in Nashville, TN. Small Smiles has three clinics in New Mexico—two in Albuquerque, one in Santa Fe.”

In fact, as Rio Grande Foundation has reported, though Small Smiles has corporate offices in Nashville, it is owned by Arcapita Bank of Bahrain.

What Now for the State’s Small Smiles Investment?

The December 2008 report by Sun Mountain Capital lists 54 New Mexico companies in which the SIC has made investments under its private equity program. Unlike the 2007 annual report, Small Smiles is no longer on the list. But $550,000 of New Mexico taxpayers’ money was invested in Small Smiles on the premise it was a New Mexico company. What has happened to that money? Has Red River been required to return it? Or has the SIC simply written off its investment in Small Smiles?

The Rio Grande Foundation posed to these questions to the SIC. We have received no direct answer, only a retort that we “obviously don’t understand private equity.”

Our research shows it is the SIC that should be asking the questions we’ve been asking. We may not “understand private equity”, but we do understand that taxpayer dollars, unbeknownst to the SIC, were invested in an Arabian owned business that abuses children, and that has been excluded from Medicaid programs because of unethical billing practices and that is under investigation in nearly every state where it operates, We—ignorant as we are about “private equity”—were the ones who brought these facts to the SIC’s attention.

Taxpayers pay the State Investment Officer Gary Bland a salary in excess of $300,000. He has a fiduciary obligation to manage our money prudently. That requires knowing what is being done with that money. In the case of Small Smiles, he has obviously failed to meet his obligations to taxpayers.

The private equity program pushed by the Richardson Administration requires the SIC to pour hundreds of millions of dollars of investments in New Mexico private equity. This has resulted in a rush to get money out the door into the hands of venture capital risk takers. The SIC does not have the staff needed to adequately supervise those investments. Consequently, the SIC has deferred excessively to outside investment firms.

We have not seen any real, traditional investment returns from the quarter billion dollars poured into the New Mexico private equity program. We are, in fact, losing money in many of those investments. The SIC does not reveal these losses in its annual reports. Instead, it continues to paint a rosy picture about its investments. That picture, as demonstrated in the Small Smiles investigation, is misleading and false.

The Legislature needs to take a hard, detailed look at the SIC’s private equity investments. It needs to dig beyond the glossy pages on the annual report. It needs to go over each of the “New Mexico companies” listed and ask of each of them: are they profitable, have they paid us any dividends, have we made any capital gains, and, if not, why in the world are we continuing to lose money in failing companies?

The only defense offered by the SIC of these risky investments is that they “create jobs.” The Legislature should also dig into those claims, and demand a company-by-company accounting of these job-creation claims. The Small Smiles investigation conducted by the Rio Grande Foundation shows that the information in the SIC’s annual report is not reliable. If claims about a small investment are so dramatically false and misleading, it calls into question the validity of claims about larger expenditures, and whether large losses are being hidden in the SIC’s files.

Monday, January 26, 2009

Complaints Still Coming In: Little To No Improvement Since Steven Adair Joins FORBA/Small Smiles

What exactly is Dr. Steven Adair doing to stop the abusive and poor quality dental care at FORBA/Small Smiles clinics?

A few months ago FORBA announced he was Chief Dental Officer. However I've been told that he's really just a part time advisor and sends out emails now and then. I don't really know exactly what he's supposed to be doing, but so far I'm not seeing much. Maybe he needs to send his emails to me as well.

Rochester, NY, Massachusetts and Cincinnati, Ohio came in over the weekend. Actually all on Sunday. Three emails from three different states and clinics and they all sound pretty much the same. It's hard to deny the fact that this abuse is widespread, isn't it?

Below are three emails I received over the weekend. Actually I got all three of these on Sunday. Just when I thought things might have gotten a bit better I find the same complaints just keep coming in.

Of course my advice to these people were to file complaint with Federal and State authorizes as well as dental boards.

I would also like to offer this:

1. Get copies of ALL of the patient chart including x-rays and make sure the parents compare the original chart to the copied records to make sure they get them all. Our office mgr is famous for only copying the pages she wanted copied which just made me furious.

2. Get those records to another dentist for a 2nd opinion or even to the medicaid office or whatever insurance they have.

3. Check with the insurance carrier or medicaid to see what was actually billed and make sure it all adds up. If it doesn't add up file a complaint with your state Attorney General and Board of Insurance as well as the agency who oversees your medicaid program.

My name is M***** C*********** and I am the grandfather of a three year old girl (A******* *******) that has had a traumatic incident with the Small Smiles clinic here in Rochester NY. A********* had in our opinion been traumatized at the dentist. She was restrained, intimidated and tortured to the point her capillaries in her eyes broke! This so called dentist insisted on capping her baby teeth to reduce further damage to her teeth!!! Her baby teeth!

This procedure resulted with my granddaughter’s gums becoming enflamed and swollen. When my step daughter (Sarah Minor) returned her to little smiles for an emergency visit she described the resident dentist as “jamming” an inspection mirror into her mouth in an attempt to PRY it open! When she freaked he exclaimed “he was bitten earlier in the day and didn’t want it to happen again”. After a short visual exam (not even five minutes) she stated “he did not see anything and for her to brush more”!

That night the pain became so unbearable for her that she was rushed to the emergency department at Rochester General. It was here that the ER dentist told Sarah she had a bad infection and required immediate surgery before it turned into a health issue!! To date she has had one such surgery and is scheduled for another due to the depth of the infection around the capped teeth!

When I did an Internet search to see if this company had any other complaints I could not believe what I read. Everything that was written by other parents – word for word- was what happened to A********. This is how I was directed to your office and am filing an official complaint!

I am going to try and contact the other parents as well as legal counsel to see the extent of our rights but someone from your end has got to do something also .All these new parents are trying to do the best they can and are being taken advantage of.

There needs to be tighter laws and regulations regarding medical practitioners dealing with children. If they think they can tie up our children and torture them with no consequences they have another thing coming!

Sincerely,

M******** L. C*******

For S******* M******** mother of A******* *********

________________________________________

Hello,
I don't know exactly where to begin...but myself and a friend are looking into the Small Smiles practices in MA, after both of our sons had questionable experiences. Her son was put in a papoose restraint for a non-emergency visit. We are serious about doing something, but are looking for advice as to where to begin. Any thoughts?
Rachel

_________________________________________

i read somewhere to contact you about small smiles. I am a former employee of the clinic in Cincinnati, Ohio and for the rest of my life i will be ashamed of the things i was made to do. i attended a dental assisting school and right after that i was sent to work at small smiles i hardly knew anything about dentistry and the laws and regulations in the dental field. small smiles told us we had to do this we don't talk about that we work fast fast fast and do as much as we can but it was never good enough! ever morning they would have a meeting about how we have to make more money in order to keep the place open. i know now that was a lie! things got so bad i watched as a doctor place a mirror so far back into a three year olds mouth that he gagged and then the doctor leaned down by his ear and told him to shut up or he will do it again!! i reported the man to the cooperate office and they promoted the doctor to regional manager!!! i couldn't take it anymore and i wanted to make dental my career and i knew i couldn't stay with small smiles and have a good conscience. Please feel free to email me back or anything I feel an obligation to help shut them down.

Friday, January 16, 2009

New Mexico Watchdogs Looking Into Taxpayer Money Given To FORBA/Small Smiles

Looks like a 'can of worms' has been opened in New Mexico in regards to FORBA/Small Smiles. It appears more 'watchdogs' are jumping on the bandwagon questioning FORBA and it's Small Smiles Clinics, especially in New Mexico.
New Mexico is where government decided to give FORBA/Small Smiles New Mexico taxpayer dollars as a gift to help FOBA open a couple of clinics. Serious questions are being raised as to why and how FORBA/Small Smiles ending up getting that money.
Below is Jim Scarantino's Report:
Nothing to Smile About: New Mexico’s Curious Investment in Small Smiles Dental Clinics

Does New Mexico’s State Investment Council know what is being done with the tens of millions of dollars it has invested in New Mexico venture capital? That doesn’t seem to be the case, at least in the instance of one curious investment.

In its 2007 annual report the State Investment Council (SIC) reported it had acquired ownership positions in 45 New Mexico companies. These investments amounted to $141.4 million. That sum includes the $19 million invested in Eclipse Aviation, which is now in bankruptcy. The report does not disclose how much New Mexico has invested in these companies or what percentage of their stock is owned by New Mexico state government as the result of these equity acquisitions.

The Rio Grande Foundation has been asking the SIC for that information for two months So far, the SIC has not been able to provide an answer. It does not seem to be any more readily available to the SIC than to taxpayers who want to know what is being done with their money.

Except for the Eclipse Aviation investment and the millions invested directly in Earthstone, a Santa Fe cleaning products company, the rest of the SIC’s current investments in New Mexico companies have been made in partnership with a venture capital funds that are based in New Mexico or have an office here, though their principal office may be in another state.

As Charles Wollmann, the SIC’s Public Information Officer explains it, the SIC relies on these investment firms to determine how much is invested in each company. Accordingly, that information is not readily available to the SIC…or New Mexico taxpayers. Indeed, Wollmann has cautioned that some of this information may be proprietary and not for public disclosure.

The Rio Grande Foundation has taken a closer look at Small Smiles, one of the 45 New Mexico companies identified in the SIC’s 2007 report. We have learned that Small Smiles is not truly a “New Mexico company” but is a multi-state chain of Medicaid dental clinics owned by out of state interests and managed by a company whose ownership can be traced back to the small Arabian nation of Bahrain. Our investigation also reveals that by investing in Small Smiles the SIC has bought into a company with a record of abusing child patients and engaging in unethical billing that has put it under government investigation. And, as we have learned, there are more public relations troubles brewing for Small Smiles.

Small Smiles, a New Mexico Company? Try Colorado, Tennessee or even the Middle East.

Small Smiles operates Medicaid dental clinics for low income children and infants in nineteen states and the District of Columbia. It began operations in New Mexico in 2007, opening one clinic in Santa Fe, one on Albuquerque’s west side and one in southeast Albuquerque.

Through its partnership with Red River Ventures of Plano, Texas, the SIC acquired equity in Small Smiles in 2007. Bruce Duty, a director of Red River Ventures, told the Rio Grande Foundation that his company invested a total of about $5.5 million in “Smile Smiles, LLC.” About 10%, or $550,000 of that investment came from New Mexico’s SIC. The rest came from other investors, including the United States Small Business Administration.

There is no New Mexico corporation identified in the records of the New Mexico Public Regulatory Commission as “Small Smiles, LLC.” Instead, the Public Regulatory Commission corporations archive reveals three Small Smiles professional corporations corresponding to each of the three clinics. Each of the Small Smiles dental clinics was incorporated as a separate professional corporation.

None of the directors of the New Mexico Small Smile clinics are New Mexicans.
The director of the Santa Fe clinic and the clinic on Albuquerque’s west side is Kenneth E. Knott. He is a Senior Vice President of FORBA of Nashville, Tennessee. FORBA is one of the nation’s largest dental clinic chains. (More on FORBA below). Knott is a busy man. He is also a dentist, and is licensed in Ohio, the District of Columbia, Connecticut, New Hampshire, South Carolina, Kentucky, Oklahoma, and Virginia. He also is the director of Small Smiles Clinics in Akron and Youngstown, Ohio, Ft. Wayne, Indiana, the District of Columbia, and Reno, Nevada.

The director of the Small Smiles clinic in southeast Albuquerque is Adolph R. Padula. He is a retired dentist from Pueblo, Colorado. He is related by marriage to the DeRose family of Pueblo, Colorado, the founders of the Small Smiles chain of Medicaid dental clinics.

The corporate records of all three New Mexico clinics give either mailing addresses or identify a principal out of state address in Pueblo, Colorado.

So how does this tie Small Smiles to the Middle East? Follow the thread a little bit further.

First, we have to go through Pueblo. That’s where Small Smiles began, growing out of the DeRose dental clinic. The DeRoses once owned a string of dental clinics across the country catering to Medicaid patients. They sold their interest in Small Smiles to FORBA. Dr. Michael DeRose, one of the founders of the Small Smiles chain, in 2007 agreed to pay the federal government $10 million to settle charges his clinics had charged Medicaid for unnecessary procedures, such as capping children’s teeth. As reported below, this is an allegation that continues to arise against Smile Smiles clinics even after the DeRoses sold their interest to FORBA.
All Small Smile clinics are now managed by FORBA, which also began in Pueblo. FORBA owns the trademark on “Small Smiles.” FORBA stands for “For Better Access.” It has grown into one of the nation’s largest dental care management companies. It reported revenue of $142.2 million in 2006. That year it was acquired by a Sanus, a Nashville-based holding company, and then moved its main corporate offices to Tennessee. It continues to maintain some operations in Pueblo.

Sanus, in turn, was acquired by Small Smiles Holding, LLC, a company formed for the express purpose of acquiring Sanus.

But Nashville isn’t the end of the line. The terminus is Bahrain. In January 2007, just before SIC’s investment in Small Smiles, Sanus sold FORBA for $435 million to Arcapita Bank of Bahrain.

In sum, instead of investing in a New Mexico company, the SIC’s partner has invested in a company owned by a bank on the Arabian Peninsula. The SIC’s 2007 report, claiming an investment in a New Mexico company called Small Smiles, is incorrect.

Grim Smiles
At the time that the SIC’s money was being invested, Small Smiles was the subject of a damning Emmy Award winning expose’ of its medical and business practices in Washington, D.C. area clinics. WJLA-TV of Washington, D.C. launched its investigative report with film footage of a screaming child being restrained on a “papoose board” while his mother was excluded from the room. The series of investigative reports also discovered that Small Smiles was using unlicensed x-ray technicians and billing Medicaid for hundreds of thousands of dollars in unnecessary dental work, including pulling children’s teeth without a valid medical reason.
“Drilling for Dollars,” triggered a criminal investigation by the Maryland Attorney General. Several insurance companies suspended Small Smiles and directed patients to seek dental work elsewhere. The report elicited complaints from patients and employees around the country that were collected at the television’s website.
In May 2008, New York terminated Small Smiles’ participation in its Medicaid program in response to reports by CBS-6 news of Albany that its Colonie clinic was performing unnecessary procedures such as needlessly crowning teeth. When Small Smiles challenged these claims, more than one hundred parents came forward with complaints of mistreatment backed by photographs. As in Maryland, parents were not permitted to be present with their children during examinations and dental procedures. A dozen parents also reported that their children were restrained on a “papoose board.” Some parents reported their children screaming in pain because the dentist operated before anesthesia took effect or operated without any anesthesia at all. Parents also reported the use of dirty dental instruments. Lawsuits have been filed by several parents against Small Smiles based on these allegations.
Small Smiles has drawn the ire of New York’s United States Senator Charles Schumer. After the New York Office of the Medicaid Inspector General revoked their Medicaid authorization, he issued a statement saying, “"I'm glad they're terminating Small Smiles," said U.S. Sen. Chuck Schumer (D-NY), a staunch critic of the company. "They don't deserve to be in business and certainly not get any federal money." Sen. Schumer says he has seen news reports documenting similar allegations against Small Smiles clinics in Denver, Rochester, and Washington D.C. "They ought to prosecute some of the people who did this," he told CBS-6 via satellite from Capitol Hill. "This goes beyond a mistake. This is hurting our children and ripping off the federal government...and I think there ought to be a criminal investigation of this."

Similar allegations against Small Smiles clinics in Kansas have been reported by The Wichita Eagle and in Colorado by KUSA-TV of Denver.
Debbie Hagan of Owensboro, Kentucky collects complaints from Small Smiles patients and parents at her blog, “Dentist the Menace.” (www.debbiehagan.blogspot.com). She also receives reports from dentists who have worked in Small Smiles clinics. One person identifying himself as a dentist who worked at a Small Smiles clinic wrote, “I was disgusted with the way children were treated. I wouldn’t take a dead snake to that place.” FORBA has sued Hagan for defamation and posting what it claims are copyrighted internal company documents. That has not stopped Hagan from continuing to run her blog.

The bad publicity for Small Smiles and FORBA may be getting worse. Good Morning America recently aired parents’ complaints against Small Smiles. Additionally, ABC’s nationally televised investigative news program “20/20” has completed a critical report on Small Smiles. According to its producer, Glenn Ruppel that report will air very soon.

What Did the SIC Know and When Did It Know It?
The SIC does not seem to have been aware of any problems with Small Smiles while its partner Red River Ventures was investing taxpayer dollars in that troubled company. A review of all the minutes of meetings from 2007 and 2008 of the State Investment Council and the New Mexico Private Equity Investment Advisers Council, which advises the SIC on private equity investments, did not reveal any discussion of nor any report on Small Smiles.
The SIC had no response when asked if it was aware of the history of problems of Small Smiles’ clinics. The SIC does say it is no longer categorizing Small Smiles as a New Mexico company.
Below is a Snippet from Mario Burgos Blog Entry:
How is it that the SIC has had so many questionable (I'm being kind here) and ill-fated investments? Well, you might remember that it has been standard policy under the Richardson administration to fire those advisors who did not want to issue rubber stamp endorsements of shady (okay, sugar-coating is not really my style) deals that Governor Richardson wanted to see approved.

That's right, I said, "Deals that Governor Richardson wanted approved." After all, the Governor is the chairman of the SIC. Now, in light of all of the recent scandals, you may be wondering if the Governor has ever received any campaign contributions from anyone connected to Small Smiles.

Well, I'm glad you asked. As it turns out, the Chairman and CEO of the holding company for Small Smiles is Michael Lindley of Nashville, Tennessee. Mr. Lindley did indeed donate a $1,000 to our Governor's presidential campaign. He also gave a $1,000 to Congressman Ben Ray Lujan's campaign.

Of course, my guess is that our Speaker of the House Ben Lujan solicited the funds on his son's behalf. After all, other than the imprisoned former State Senator Manny Aragon, the only other elected official to recieve funds cycle after cycle from Small Smiles in New Mexico is Speaker of the House Lujan.

Thursday, January 08, 2009

New Mexico Investment Council Blasted For Small Smiles Investment

Remember a week or so ago I reported on Small Smiles in New Mexico. Plus I had reported last year that I thought it was odd the two top dogs at FORBA had made political contributions to a New Mexico lawmaker. Well, it appears others in New Mexico have taken notice to Small Smiles as well.

Click Here for the Story

State Investment Council needs a closer look

By Paul Gessing/For the Sun-News

Posted: 01/08/2009 12:00:00 AM MST

The pending loss of New Mexico's $19 million investment in Eclipse Aviation raises important questions about how wisely the State Investment Council (SIC) is handling our money. This is not the first private equity investment by the SIC to go sour. New Mexico lost a $7 million investment in TCI Medical, a start-up nuclear medicine company that was supposed to create 100 jobs in Carlsbad but employed just seven people. The SIC also lent about $2 million to Millenium Transit, a bus manufacturing company in Roswell. That company is now in bankruptcy.

The SIC does not seem to know exactly what is being done with New Mexico's money. It claims to have bought equity positions in 52 New Mexico companies, but it cannot say, despite repeated requests by the Rio Grande Foundation, how much money it has in each of these companies or what percentage of each company's stock is owned by New Mexico taxpayers.

The Legislature, at Governor Richardson's urging, has authorized the SIC to invest up to 9 percent of the Severance Tax Permanent Fund in acquiring stock in private New Mexico companies. This is a substantial amount of money. At the end of 2007, the SIC had over $141 million invested in private New Mexico companies.

So far, the SIC's New Mexico private equity program hasn't produced hard returns for New Mexico taxpayers. For years, the SIC claimed its New Mexico private equity program was in the black. But favorable (and inflated) valuations for Eclipse, the largest holding in the portfolio, accounted for those paper gains. With Eclipse in the tank, the false bloom is off the rose.

Even some of the SIC's smallest acquisitions look questionable. Take for instance, its investment in Small Smiles. The SIC's 2007 annual report showed an investment of an unstated sum in this New Mexico company. By directly contacting the venture capital firm that handled this investment, the Rio Grande Foundation learned that about $500,000 New Mexico taxpayer dollars have been invested in Small Smiles. The SIC itself had not been able to answer this question.

Contrary to the SIC's annual report, Small Smiles, is not a New Mexico company. It is a national chain of low-income dental clinics owned by a bank in Bahrain. Furthermore, at the time half a million taxpayers dollars were going to help Arab investors, Small Smiles was being blasted in an Emmy Award winning investigative television series called "Drilling for Dollars." Small Smiles clinics in the Washington, D.C. area were exposed for abusing children by strapping them to "papoose boards." Small Smiles had engaged in unethical billing practices. Parents came forward with complaints of unnecessary dental work being performed on their children without their consent.

The same complaints about Small Smiles arose in New York, Colorado and Kansas. New York Senator Charles Schumer has called for criminal prosecution and disqualification of Small Smiles from the Medicaid program. New York, in fact, did revoke Small Smiles' Medicaid credentials.

A review of SIC meeting minutes shows not one mention of Small Smiles' difficulties. In fact, Small Smiles wasn't discussed once though a half million dollars were invested in this troubled company.

The Eclipse bankruptcy proves that politicians and their appointees make very poor judges of the next big breakthrough in aviation or other technologies. The fact that even in its smallest investment the SIC seems less than completely informed should make taxpayers concerned about whether their money is being prudently managed.

There is scant oversight of the SIC's investment practices and decisions. Only when a big investment like Eclipse craters does the public learn of losses. It's time the Legislature revisit the discretion it has given the SIC, and provide for greater transparency and more informed decision making. It should also ensure inescapable accountability for those who make the wrong calls in handling the public's money.

Paul Gessing is the President of New Mexico's Rio Grande Foundation, an independent research and educational organization dedicated to principles of limited government, economic freedom and individual responsibility.

Small Smiles Investor Receives Bail Out Money

Cit Group received 2.33 Billion in Bail Out (TARP) money according to the website.

Since I have never professed to understand the complicated maneuvers FORBA/Small Smiles made in late 2006 I'm not going to even try to explain the relationship between Cit Group and FORBA/Small Smiles other than to quote an article from streetinsider.com.

November 20, 2006 3:37 PM EST

American Capital Strategies Ltd. (Nasdaq: ACAS) has invested in Small Smiles Holding Company LLC, a holding company formed to acquire Sanus Holdings Inc., a leading dental practice management company. American Capital's investment takes the form of senior subordinated debt, holding company PIK notes and common equity and supports the acquisition of Sanus by affiliates of Arcapita Inc. and the Company's senior management.
A syndicate led by CIT Group Inc. (NYSE: CIT) has arranged a revolving credit facility and a senior term loan. The Company's management team and private investors are investing in the equity of Small Smiles.

Wednesday, January 07, 2009

Is Kool Smiles Coming To a Place Near You?

Here is an anonymous email that stated:

I am a dentist that currently works at Kool Smiles. There are many corporate habits that just turn my stomach but I go along because they keep paying me. One thing is that we do not do is change rubber gloves between patients. Can you imagine the health risks that we are taking doing this?

It makes me sick.

Something must be done.

FFl have given Kool Smiles in Atlanta 48 million dollars to expand and DPMS (in San Ramon, CA) another 48 million to expand so they can sell the company off in 2010.

If people are visiting your site, they must be concerned about the impact that you are having with everyone reading your blog. They want to sell the whole thing to someone for hundreds of millions of dollars.

FFL (Friedman, Fleischer and Lowe) has two companies to keep an eye on in their portfolio.

DPMA

From FFL's, Website:

DPMS, Inc. provides various non-clinical services to dental group practices, including providing dental facilities, support staff, and other business services. DPMS's principal client is Kool Smiles, a nationally-branded provider of dental care focused primarily on children enrolled in Medicaid and State Children's Health Insurance Programs. The limited access to care for children on Medicaid/SCHIP plans provides an attractive growth opportunity for Kool Smiles as it continues to expand offices with a mission to provide quality care to this underserved population.

The company was founded in 2006, and is headquartered in San Ramon, CA.

and

NCDR, LLC (Kool Smiles)

From FFL website:

NCDR, LLC provides various non-clinical services to dental group practices, including providing dental facilities, support staff, and other business services. NCDR's principal client is Kool Smiles, a nationally-branded provider of dental care focused primarily on children enrolled in Medicaid and State Children's Health Insurance Programs. The limited access to care for children on Medicaid/SCHIP plans provides an attractive growth opportunity for Kool Smiles as it continues to expand offices with a mission to provide quality care to this underserved population.

The company is headquartered in Atlanta, GA. FFL invested in NCDR in 2004 to provide growth capital and liquidity to founders.

Thursday, January 01, 2009

Small Smiles Seeking Dentists In Several Clinics

If you are interested in a job with Small Smiles in any of the following cities:

Aurora, Colorado

Colorado Springs, Colorado

Pueblo, Colorado

Reno, Nevada

Wichita, Kansas

Oklahoma City, Oklahoma

Tulsa, Oklahoma

Montgomery, Alabama

Dothan, Alabama

Roanoke, Virginia

Albany, New York

or

Boston, Massachusetts

and are interested in treating young underserved children they offer excellent base salary, promotion opportunities and benefits (including monthly bonus potential, then click here to apply.

Monday, December 29, 2008

Aggressive or Overtreatment

In an interview a Small Smiles lead dentist, Aldred Williams said:

"We aggressively treat these children to eliminate disease in their mouth. Small Smiles makes no apologies for that. I'm not going apologize for being aggressive," Williams said.

The word 'aggressive' really bothers me. What's worse is to think thats the 'training' the dentists get (could call in brainwashing I suppose).

I guess a person could insert "overtreat" in place of "aggressive" couldn't they an it still have the exact same meaning.

Of course I don't think Dr. Williams is there any longer after saying that publicly to the mainstream media.

I got this particular quote from the Good Morning America story on Small Smiles, but it was said in the interview with Roberta Baskin at WJLA aas well, I believe.

Here are other quotes from the Good Morning America and WJLA TV story:

1. Former Small Smiles dental assistant, Deborah McDaniel, said she was fired for objecting to the way children were being handled.

2."They wanted us to tell parents that they needed services on teeth that were healthy," McDaniel said. "They were healthy and they didn't need it."

3. "It's a competition throughout the country to see who can convert the most patients, not give the patients the most care," said Trina Crosby, another former Small Smiles employee.

4. The pressure to convert patients may come from FORBA. In fact, every morning Dr. Williams and his staff review the production goals set by the managers in Colorado.

7."They're sweating. Sometimes they urinate on themselves. They'll throw up," Crosby said.

5."It does no good for anybody but the dentist, I guess, who's looking for a bonus," said Robert Camps, a nationally recognized authority on pediatric dentistry whose Maryland practice serves mostly patients on Medicaid.

6.When Camps saw video of Miguel's dental visit, he was disturbed deeply. "It's traumatic for me to watch. I can only imagine how traumatic it is for Miguel," he said.

7.FORBA, the company that owns Small Smiles, said its dentists and staff are sent to its Colorado offices for training. (but I hear only the "lead" dentists are sent for training)

There were 158 comments on this story, you can read all of them here.

Here are just three:

1. I think ABC news should do an undercover investigation on the Small Smiles chain. I mean in every clinic. In one month's time, you would uncover mistreatment of children, insurance fraud, ADA violations, etc. As someone mentioned before - when a new doc joins a clinic and are yet to be accredited with an insurance company - other docs sign off on the chart and the insurance is billed under the signing dentists name. BTY - although it was never publicized, the chain is now within the 'portfolio' of a middle eastern bank. In other words, FORBA and Small Smiles is actually owned by a Bahrainian business group. There is so much more I could say - I can only pray that this story does not wither away. I would love to see the Federal Government step in and conduct an indepth chart by chart audit at every Small Smiles site.

2. I will join the ranks of the 'former employees'. I my year and a half at Small Smiles, I saw and heard so much abuse to children, that I actually developed an ulcer. I fought on a daily basis about the manner in which the docs, assistants, and hygienists were allowed to speak to the children. I witnessed the lead doc getting about 6 inches from the face of a crying, terrified, restrained child and yell at the top of his lungs, "That's enough. Stop being a punk." We were often directed to separate siblings. Especially older siblings that would overhear any yelling at their younger sibs. Competitions on converting....any employees remember "The Road to the Superbowl"? We were also trained to forbid parents in the back clinical area. If the parent balked (especially when there was a several thousand dollar treatment plan), the lead doc, in all his arrogance, would have me escort the parent to a consultation room, and proceed to tell the parent that dental work is just as serious and important as heart surgery and that they wouldn't be allowed in the operating room. WTF ever! The insurance fraud is OUT OF THIS WORLD!!! I was instructed to bill for prophys (cleanings) when all that was done was about a 2 minute tooth brushing with some toothpaste. No prophy angle, no scaling, nada. But I was told to bil a full prophy. I questioned that so much, I was actually told that if I asked and further questions and/or 'stirred the pot' any further, my job would be in jeopardy. I do have to add, that the original FORBA was much more caring than the 'business men' that bought FORBA at the end of 2006. The 'new' management was PURELY about the money. The 'old' FORBA cared about its employees and patients. The new FORBA - in an email that was accidentally forwarded to me had these requirements for a dentist - 'if she isn't cross-eyed and has all 10 fingers, let's make her an offer' sadly, I regret not forwarding that email to the dentist in question.


3. I am an employee at a pediatric dental office and very, very familiar with Small Smiles and their practices. Before you judge them you have to look at all angles of the situation. I live in Colorado, and here, there are so many loop holes and in dentistry and things that are not regulated in dentistry that that in itself should be a crime and the state of Colorado should be looking at that and not just be pointing the finger at Small Smalls. Each clinic is so different that you can not judge all of them as a whole. They are a corporation but they are run individually and some by a bunch of morons who don't know dentistry from gardening. Others of the clinics are run by a fabulous staff who really know their patient care, legalities, and methods. The sad part is knowing who is who. I stand up for Small Smiles because I have so many friends in the dental community who work at great clinics and others who work at ones who honestly do not know how to treat their staff or their patients. Like I said above, you can not only point your finger at the clinics. You have to look at the laws and you have to look at the parents who bring their children in. Until I became a CDA - EFDA I did not even know that baby crowns and root canals existed for two year olds, and I did not think that a 14 year old mom with three other kids was going to be handing me this child to do the work on... so you tell me when this 2 year old is screaming and crying after riding on the bus an hour from home with his mom and other 3 brothers and sisters in the cold of you are going to have mom come back to the room with all the other kids???? or tell me that you tell me that you are going to have a meth addicted parent come back and try to calm their child when THE PARENT keeps saying shut up and sit in the chair. Please do not get me wrong either, I am not saying that anyone is a bad person if they are on Medicaid at all, never would i say that.


Monday, December 22, 2008

Virginia Releases December 2008 Smiles For Children Report

Virginia's Smiles For Children December report is out. It appears the enrollment of dentists is up 80%.

In the report it talks about the use or over use of papoose boards;

"The practice of behavior management techniques during necessary dental treatment of children has also been a continual focus of the Smiles For Children program. Inquiries have been received by the media and parents of dental patients regarding behavior management techniques, specifically, protective stabilization through the use of papoose boards. Papoose boards are devices commonly used to immobilize children for dental work. If performed improperly, trauma to a child may result.

According to the American Academy of Pediatric Dentistry, protective stabilization is an approved method of behavior management, and pediatric dentists receive behavior management training during post graduate education. These techniques are allowed under the scope of practice,
as defined by the Virginia Board of Dentistry, for licensed dentists in Virginia."

Here is the sticky part of this, hardly any dentist who work in these dental mills like Kool Smiles, Small Smiles and others are NOT pediatric dentists most are general dentists. I notice Dr. David M. Strange, DDS MS is still listed as one of the Advisory Committee, you may remember him from Kool Smiles.

Friday, December 19, 2008

Kool Smiles Pays U.S. Over $1Million

Dental Clinic Business Settles $1 Million Claim

December 19. 2008

NBC WYFF TV, Channel 4

GREENVILLE, S.C. -- An Atlanta-based dental healthcare provider with clinics in Sumter, Anderson, and Greenville has agreed to pay the United States more than $1 million to settle a claim.

Kool Smiles PC, Inc. was accused of billing Medicaid for the work of an unauthorized dentist in the Sumter area.

The dental health care provider agreed to pay a total of $1,360,528 to resolve allegations that it submitted claims to Medicaid for services provided by the dentist who had previously been excluded from all federal health care benefit programs, including Medicaid.

The dentist in question was disqualified for Medicare funding because she had failed to repay more than $22,000 in federal student loans, according to U. S. Attorney Walter Wilkins.

Under the agreement, Kool Smiles will repay all the money it received from Medicaid for the services provided by the dentist after she was excluded, plus interest and investigative costs.

Under the settlement agreement, Kool Smiles will repay all the money it received from Medicaid for the services provided by the dentist, plus interest and investigative costs.

Wednesday, December 17, 2008

Parents Comment on WAVY TV Report

Click here to read even more of the comments from parents after WAVY TV reporter Derrick Rose reported on Kool Smiles in Virginia

Tuesday, December 16, 2008

Louisville Small Smiles Clinic Owner Not Mentioned in Press Release

Over at FORBA's weblog they have an entry where they had an open house for the Small Smiles Clinic in Louisville, Kentucky.

Melanie Abrams was mentioned as Co-Lead Dentist ('lead dentist': a term used a lot at Small Smiles) but through the whole article the owner of the clinic wasn't mentioned, just Forba and lead dentists.

You would think if a dentist opened a new dental clinic his name would be mentioned.

According to Kentucky Revised Statues (KRS) 313.240 states:

(1)(a)"No person shall practice or offer to practice dentistry or dental surgery under the name of any company, association or corporation except the name of a professional service corporation. Any person practicing or offering to practice dentistry or dental surgery shall practice under his or her own name; the name of the professional service corporation, professional limited liability company or partnership which includes his or her name, or the name of the deceased or incapacitated dentist for whom the person practicing dentistry has contracted to perform continuing operations."

(b) No such person shall conduct a dental office in his or her name nor advertise his or her name in connection with any dental office unless he or she personally performs services as a dentist or dental surgeon in such office or personally supervises such services as are performed in such office during a portion of the time such office is operated by him or her, and shall not use his or her name in connection with that of any other dentist, except as provided for deceased or incapacitated dentists in KRS 313.197

(c) No person shall be an incorporator, director, officer, member, manager or shareholder in more than three (3) professional service corporations, three (3) professional limited liability companies, or three (3) partnerships, or any three (3) of these business entities, rendering dental or dental surgery services. No dentist or dental surgeon or group of dentists or dental surgeons shall practice in more than three (3) locations.

So Jodi Kuhn couldn't possibly be the owner of this clinic, it's said she owns 4 or so in Ohio. Who could be the owner of this Louisville clinic?

Friday, November 28, 2008

Fighting For The Children Gets Blogger Sued by FORBA-Small Smiles

Well it's finally happened, to some I'm sure they are so enjoying it but to others not so much.

FORBA is suing this blogger for defamation among other things like posting that very revealing list of all their clinics and the numerous name they go under.

I'm not sure exactly what they want. I signed a Consent Injunction agreeing to remove the documents they let get put out on the world wide web. I guess they really weren't realizing what the www stood for when posting stuff on the Internet for all to see. They are claiming the documents were trade secrets or copyrighted.

However I don't understand how they can claim something is a 'Trade Secret' when it appears they released them to the Internet to be indexed and cached by Google.

I have until December 4, 2008 to file my ''Answer" to their Complaint. However I guess they are wanting to bombard me with legal papers since today I received a package, well actually 2, they sent one certified and the other just regular mail, seems like a waste to me, but whatever.

In this packet were their first set of Interrogatories. Questions they want me to answer under oath, it's part of the 'Discovery' stage in a lawsuit. I wish they would at least let me file my answer for heavens sake.

They've not cared what has been said or posted on this blog since it's beginning in January 2008, but the moment I posted a spreadsheet that could be incriminating depending on how you see it, I was slapped with a lawsuit. Guess I really hit a nerve and there were things on the document they sure didn't want anyone to see. They could have easily sent a Cease and Desist letter or request a retraction at any time but they never bothered.

Honestly I'm not sure why they worry about my little ole blog anyway. They are my biggest visitors. In fact if they didn't visit so often my blog probably would rate as high as it does in the search engines.

This is all been filed in Federal Court since it involves 'trade secrets' and we are in two different states.

Funny thing is, I think FORBA is involved in a lawsuit in Texas over copyright infringement themselves between a dental clinic called Texas Smiles Dental and them setting up shop down there under the name Texas Smiles. Kettle-Black, right.

I now clearly understand what employees mean when they post that they are bullies and you better shape up or ship out or they will come down hard on you. (paraphrasing here) They certainly play hardball.

I'm wondering why they decided it was me they went after. After all they have been on news stations and had several thorough investigations done on them by the main stream media, heck they were even on Good Morning America. My guess is that I'm the easiest target and they are mad and need to take it out on somebody.

But as bad a reputation as they have, being in the news numerous times, have horrific reviews on hundreds of message boards all over the Internet, seem to me they are kind of libel proof. If a person is bad and has been bad for a long time, and it's been common knowledge kind of hard to get upset and cry foul just because someone else joined in on that opinion for example.

I also understand how the parents of the patients who have suffered at the hands of FORBA's Small Smiles dentists and not having the funds or resources to bring suit and fight for your rights in court.

Anyway like I was saying, today I got my Interrogatories and boy some of the questions on there are ambiguous and down right silly to say the least.

I'll give you some examples:

1. Name internet domain names (by URL) and email address that you have created controlled, owned, used, and or operated in the past or present.

2. Identify (by make and model) all computers from which you have updated the website and all computers you have sent or received email over the past 5 years!

3. State all facts, and identify all documents and 'things' evidencing such facts, of which you are aware that support your representation that:

a. FORBA practices abusive dental care

b. dental clinics managed by FORBA have quotas to meet with respect to the number of patients served per day.

c. FORBA does unnecessary dental work, abuses children for profit and fraudulently bills medicaid.

4. Produce all records (whether in digital, paper or any other form) of all entries posted to the website, whether or not those entries still appear as of today's date.

(I guess they want me to pull stuff out of thin air, or create things that are just not there, gone and forgotten about)

5. Produce your home computer and any and all other computers you have used in the last 5 years for email correspondence for inspection and for the purposes of making a forensic image of the hard drives of such computers.

(I sure would like to have a little 'look see' in all their computers too, oh and all their correspondence and emails, and documents and files etc.)

The local Cyber Cafe is going to be a bit upset when I try to take one of their computers, telling them I had to cause FORBA wants it.

6. Produce all documents and 'things' that reference or reflect any posting by you to any Internet website other than my blog where such posting discusses or relates to FORBA.

Like I said, these are just a few of their requests. I have the right to object to each and every one of them.

I'm taking it FORBA / Small Smiles wants to stay in the news for as long as possible.

Anyway if you want to see the complaint, send me an email and I'll get you a copy.

What we have here is a very slippery slope where our First Amendment Rights are being attacked. I for one can tell you FORBA sure doesn't want to be critiqued, doesn't want you to have a negative opinion of them, or try to get laws changed so that clinics like them can't operate in states. Which is an infringement on my (our) right to petition.

They are giving me much more credit that I deserve if little ole me can do more damage to their reputation that main stream media and highly regarded investigative reporters. I should be flattered.

Anyway this has just given me something else to fight with FORBA about.

Friday, November 21, 2008

More Parents Respond To Kool Smiles Report By WAVY TV Reporter Derrick Rose

Click here to read all the stories from parents. They just go on and on, story after story and who is stopping this? Nobody so far!

Monday, November 17, 2008

WAVY TV Reports on Complaints about Kool Smiles

WAVY TV's , an NBC affiliate serving Norfolk, Portsmouth and Newport News Virginia, Derrick Rose reports on the usual complaints about the treatment of children at chain dental clinics catering to underserved children on medicaid that are operating in various states across the US.

Kool Smiles was created by Dr. Tu Tran and Dr. Thien Pham who trained with then broke from Drs. Michael DeRose and Dr. Ed DeRose who were the creators of Small Smiles/FOBRA that has hit the news in many areas including Good Morning America.

Click Here To Read Derricks Report

Thursday, October 30, 2008

Forba/Small Smiles Entering Orthodontics Market

Looks like just doing unnecessary dental work. abusing children for profit and fraudulently billing medicaid isn't enough for Small Smiles. They are now looking to venture into orthodontics.

See job listing for an orthodontist in MA.

If their orthodontic work is anything like their general dentistry work the children's teeth will go from perfectly aligned to completely screwed up.

If you are an Orthodontist applying for a job at Small Smiles I suggest you do your homework before even thinking about considering a job with this horrible company.

Wednesday, October 08, 2008

Small Smiles New Signage For It's Albany, NY Clinic

007 This is the new face of Forba's (Small Smiles) Clinic in Albany, NY.
It's now called Access Dentistry Albany on the window, however when Dr. Izadi was looking for new employees online his email was albanyaccessdentistry.com.

005 As you can clearly see Dr. Izadi is still there just as he was when the place was called Small Smiles.

Look, it's clear that as Small Smiles hit the air waves there under a cloud of allegations of Dr. Izadi abusing children and defrauding Medicaid Forba simply changed the name of the clinic, had Dr. Izadi apply to receive Medicaid payments directly instead of through Forba and it was business as usual. They didn't skip a beat. Within 10 days of being shut out of the NY Medicaid program in May of 2008 they were back in business. I'm not sure they ever locked the door on the place during those few days.

It's reported that payments from Medicaid are deposited into a bank in Wisconsin and guess where Forba/Small Smiles banks, yep Associated Bank located in Wisconsin.

Don't be fooled folks, this is still the same Small Smiles office that was reported on by Steve Flamisch, they have just changed the signage. Be sure to see his reports on this site.
Do Not take your children there for dental care!

Tuesday, October 07, 2008

Dad tackles Smile Starters Dentist

It doesn't look like things have changed any under the so called new management at Smile Starters in North Carolina.  (BTW, it's still under Michael DeRose control)

Here is a comment I got just two days ago.

My friend took her son there for his first dental visit and has vowed never to return. She managed to witness the staff attempting to restrain her infant son into a straight jacket, which they said was needed to keep him from moving and potentially injuring himself. Then she checked a little later and the doctor had a fist inches away from her sons face at which point her husband tackled the doctor and she grabbed her son. They are suing.

Wednesday, September 24, 2008

Current Review Shows Nothing Has Changed At Small Smiles

Recent Review of Dr. Erin Haggard at Small Smiles in Oklahoma City:

This was posted 8-20-08, just a few days ago. After reading it you can see NOTHING is changing at Small Smiles.

My friend just took her 3 year old son to this place and had a nightmare experience. They tied him up and didn't notify her, she only found out because he wet his pants and when she asked him what happened he said they didn't let him go because he was tied up. When she went back in to ask them about it they said that it was something common for them. The treatment they gave him was silver caps, which she found out later were absolutely not necessary. The reason she found this out was because he had a big cut on his lip (which they claimed was from him bitting himself) and the cut got a really bad infection, which SS wouldn't treat so she had to go to another dentist and that's when she was told the caps were not even needed.
Needless to say, this place is HORRIBLE!
Just ask yourself: why won't they let you go to the back with your child?!

Tuesday, September 23, 2008

"Drilling For Dollars" Wins Emmy

image On Monday evening, September 22, 2008, Roberta Baskin, was awarded a national Emmy for her multi-part exposé on Small Smiles, a chain of pediatric dentist centers that preyed and profitted on children and the Medicaid system. Roberta previously won the Scripps-Howard Award for National Journalism for her series.

Thursday, September 18, 2008

Comment From Nancy Mastreno

Below is a comment I received the other day. I will say these kind are few and far between but they show the ignorance of some people. I wonder if Nancy ever stopped to wonder just where a dentist got the kind of money the DeRose's portray they have. Giving millions here, hundreds of thousands there, establishing million dollar endowments at Universities etc. For heavens sake Michael and Eddie were just dentists! Nancy needs to get a clue. I bet there are a few of my readers who would love to enlighten Ms. Mastreno.

Who are you and what kind of a grudge do you have. You really need to get a life. I have known the DeRose family almost my entire life and have witnessed their generosity. Yes, they and many others contributed to building this stadium and bringing football back to CSU Pueblo. It is great for the community and the school. My first dental assisting job was with Dr. Eddie when I was still in high school many many years ago. I am still in dentistry, but in another dental office with no connection to the DeRoses, and I have nothing but respect for this family. They have given back to this community many times over and most people don't even know how generous they are because they don't give with the condition of posting what they do. You must need to get a life and stop being so obsessed with this family. Nancy Mastreno

Saturday, September 13, 2008

Albany Access Dentistry - Former Small Smiles Still Getting Medicaid Dollars

Dentists Getting State Money, Despite State Investigations

August 14, 2008 - 7:43PM
They're under state investigation, but they're still collecting state money.
Small Smiles Dentistry, which removed all traces of its name in late May, is now known simply as a "dentist's office." New York terminated the Colonie children's dental clinic from its Medicaid program on May 24, but the two remaining dentists subsequently applied for and received their own Medicaid provider numbers, a source in state government said.

That means they are legally working on children and collecting state reimbursements, even as three state agencies investigate their alleged misconduct.

Those allegations, made by three ex-employees and 107 parents, mirror claims made against Small Smiles locations in several other cities nationwide: that dentists performed rushed and unnecessary procedures in pursuit of lucrative bonuses and Medicaid money. Your taxpayer money.

In a recent survey of 29 Small Smiles parents:

  • 17 / 29 said they requested -- but were denied -- the ability to sit with their child(ren) during treatment
  • 12 / 29 said their child(ren) was/were placed under a papoose board, unable to move his/their arms and legs

  • 3 / 29 said they did not consent to the use of that papoose board in advance
  • 18 / 29 said the dentist placed crowns on their child(ren)'s baby teeth (as many as eight crowns in one sitting)
  • 12 / 29 said their child(ren) developed complications, including bleeding, infection, and severe pain
  • 6 / 29 said another dentist later told them the work done at Small Smiles was not necessary
In sometimes scathing statements, a few parents said their children were screaming in pain because the dentist did not wait for the Novocain to take effect, or skipped it altogether. Other parents described staff members placing dirty instruments back in the drawer, or in their child's mouth.

With the parents' written permission, CBS 6 mailed copies all of the questionnaires and statements to state investigators from three departments. One agency -- the State Education Department's Office of Professional Discipline -- had filed a subpoena, requesting related documents. That agency licenses the dentists.

Small Smiles corporate spokesman Don Meyer, who has called CBS 6's reporting of the allegations "a striking case of substandard journalism" full of "baseless claims," offered a generic response to the parents:

"We handle parent concerns on a case-by-case basis. Parents are encouraged to contact their child's dental center directly (464-0402) or call our 800 number. As previously stated, we take any concern seriously, and take immediate action to remedy problems if and when they occur."

Meyer promised an explanation for the name change at the Colonie clinic, but he had not offered one by Thursday night.

Stay with CBS 6 News for the latest on the state investigations.

EDITORIAL NOTE: Dr. Maziar Izadi, who retreated from a CBS 6 camera crew when approached for comment in March, is still practicing at the former Small Smiles clinic. CBS 6 is withholding the name of the other dentist because he, unlike Izadi, was not named by any parents.

Most parents said they didn't know who worked on their child(ren), because they never met the dentist. Only a dental assistant came to the waiting room to speak to them.