Showing posts with label Monarch Dental Illegal. Show all posts
Showing posts with label Monarch Dental Illegal. Show all posts

Monday, December 10, 2012

S & P down grade of Smiles Brands put it a step closer to bankruptcy, hopefully

S & P cuts Smile Brand Group rating, revises outlook
-- U.S. dental practice management services provider Smile Brands Group Inc. had negative free operating cash flow after elevated capital spending for the past four quarters, resulting in depleted liquidity.
-- Early in 2013, we expect Smile Brands to bring capital expenditures, mainly for new dental offices, into line with internally generated cash flow.
-- We are lowering our corporate credit rating on Smile Brands to 'B-' from 'B' and revising our rating outlook to negative. At the same time, we are lowering our rating on the company's senior secured debt to 'B-' from 'B'.
-- The negative rating outlook reflects the possibility that Smile Brands will exhaust the $13.5 million of funds available from its revolving credit facility as of Sept. 30, 2012, or breach a loan agreement covenant.
Rating Action
On Nov. 21, 2012, Standard & Poor's Ratings Services lowered its corporate credit rating on Irvine, Calif.-based Smile Brands Group Inc. to 'B-'from 'B'. At the same time, we revised the outlook on the rating to negative
In addition, we lowered our rating on Smile Brands' senior secured debt to 'B-', in conjunction with the downgrade, from 'B'. Our recovery rating on this debt remains unchanged at '3', indicating our expectation for meaningful (50% to 70%) recovery of principal in the event of payment default.
The rating on dental practice management (DPM) services provider Smile Brands Group Inc. continues to reflect its "vulnerable" business risk profile (according to Standard & Poor's Ratings Services' criteria), characterized by its narrow scope of operations in intensely competitive markets with low barriers to entry.

Smile Brands had negative free operating cash flow (FOCF) after elevated capital spending for the past four quarters and we expect this to continue in the fourth quarter of 2012. Our downgrade is based on the expectation that early in 2013, Smile Brands will stem the trend of negative FOCF by reducing spending for new dental offices or taking other actions, such as paying interest on its holding company debt in kind, rather than in cash. 
We also expect adjusted debt to EBITDA will rise to about 8x by the end of 2012, significantly higher than our prior expectations, but still consistent with a "highly leveraged" financial risk profile. As of Sept. 30, 2012, debt to EBITDA was 7.7x, adjusted to capitalize operating leases and including holding company debt. We have lowered our expectations for Smile Brands' revenue growth, EBITDA generation, and cash flow over the next one to two years.

We expect revenues will grow at a mid-single-digit annual rate, somewhat faster than the total U.S. dental services industry over the next few years, primarily fueled by Smile Brands' geographic expansion and a slowly strengthening economic climate. Our prior growth expectations were mid- to high-single-digit annual growth. 

Although Smile Brands' revenue growth slowed in the second and third quarter of 2012, revenues increased 4.2% for the 12 months ended Sept. 30, 2012. 
We believe an unsuccessful marketing strategy, which was subsequently abandoned, contributed to the growth slowdown. Still, we believe underlying industry fundamentals remain sound and relatively resistant to downturns. During the 2008 to 2010 recession, when revenue for the total U.S. industry was nearly flat (according to data from the Centers for Medicare and Medicaid Services), Smile Brands grew modestly, supporting our expectation for continued, albeit modest, growth.
As newer offices mature, we expect the lease-adjusted EBITDA margin (11.7% in the third quarter of 2012, compared with 12.8% in the third quarter of 2011) to gradually recover to the 12% to 14% range, with some quarter-to-quarter variation. 
Smile Brands' profitability is supported by its infrastructure, economies of scale, and supplier discounts. More rapid office expansion in recent quarters contributed to lower profitability. Smile Brands' EBITDA margin (adjusted for leases, stock compensation and nonrecurring items) began to dip in the fourth quarter of 2011, after rising substantially and steadily from 8.9% in 2005 to 14.8% for the 12 months ended Sept. 30, 2011. Our lowered expectations for 2012 and 2013 EBITDA also affect cash flow generation Smile Brands' affiliated dental practices operate a network of approximately 350 dental offices that offer general and specialty dental services. 
The $110 billion U.S. dental practice industry is extremely fragmented and highly competitive, contributing to our vulnerable business risk assessment.
Treatment volume, especially for more discretionary services such as orthodontics, and patient financial capacity exhibit some sensitivity to economic conditions. The availability of financing for patients influences demand. 
We also see vulnerabilities in the nature of the DPM structure. While we believe potential changes in state or federal laws, regulations, or accounting rules could hurt the DPM industry, we do not currently incorporate any adverse developments in our base-case scenario.
The DPM business model has many retail industry attributes, and so carries risks associated with advertising and promotion, branding, and real estate selection, among others. Smile Brands markets its brands, selects high-traffic office locations, and offers customers convenient hours, comprehensive treatment, financing, and prices typically 15% to 25% below those of traditional dentists. It targets middle-income patients in growing metropolitan areas. Affiliated offices operate in 18 states, but there are material concentrations in Texas and California.
The company provides administrative, financial, and operating services to affiliated professional corporations (PCs). Although the company does not own the affiliated PCs, its financial statements consolidate them. Smile Brands generally owns the dental office assets, but dentists and hygienists generally are not employees of the company, in accordance with state laws. 
We analyze the consolidated financial statements on the basis presented (adjusted for the capitalization of operating leases and other standard adjustments) because we believe they best reflect the economic substance of the company's business model.
We revised our assessment of Smile Brands' liquidity to "less than adequate" (according to our criteria), reflecting its diminished liquid resources.
As of Sept. 30, 2012, Smile Brands reported a negative cash balance of $0.5 million, and $13.5 million was available from its $35 million revolving credit facility. We believe Smile Brands may borrow an additional $1 million to $5 million in the fourth quarter of 2012.
We estimate Smile Brands will generate about $20 million of funds from operations (FFO) in 2012 and $25 million in 2013. We expect small, if any,annual increases in working capital. We project about $32 million of capital expenditures in 2012 (actual spending for the first nine months was $27.5 million), including the recently completed roll out of digital x-rays. In 2013, we expect Smile Brands to bring capital expenditures, mainly for new dental offices, into line with internally generated cash flow. We believe annual maintenance capital spending is less than $10 million.
Our assessment of Smile Brands' liquidity profile incorporates the following assumptions and expectations:
-- Over the next 12 months, we expect sources of liquidity, including potential borrowing under the revolver, to exceed uses by 1.2x. Even if EBITDA is 15% below our projections, we estimate liquidity sources would cover cash needs, although in that scenario the revolver could be fully drawn.
-- Debt amortization is only $2.4 million annually through 2014.
-- Our analysis of Smile Brands includes unrated holding company notes with a face value of $100 million ($87 million after the original issue discount). Smile Brands has been paying the 10% coupon in cash. To conserve cash, we believe it may begin to pay interest in kind at 13%.
-- We expect Smile Brands to remain in compliance with its loan agreement covenants, notwithstanding requirement tightening. As of Sept. 30, 2012, there was a 17% cushion under the tightest covenant.
-- We assume Smile Brands will not make any acquisitions over the next two years.
Recovery analysis
For our complete recovery analysis, see our recovery report on Smile Brands, to be published following this report on RatingsDirect.
Our negative rating outlook on Smile Brands reflects the possibility that it will exhaust the $13.5 million of funds available from its revolving credit facility as of Sept. 30, 2012, or breach a loan agreement covenant. We would consider lowering the rating if negative FOCF persists in the first quarter of 2013 or we expect the covenant cushion to approach 5%.
We would consider revising the outlook to stable if Smile Brands generates discretionary cash flow (through a combination of improved EBITDA and lower capital spending), restores availability of its revolver, and we expect the covenant cushion to stay above 15%.

Monday, March 05, 2012

Galdi v Megdal and Bright Now! Dental

Anyone know what this is about:

Case No: United States of America Cr-02-00349CAS
Case No YCO30202: Galdi vs. Megdal

Mimi Villegas Galdi


Bright Dental Now! Phillip Megdal,
Jordan Moss,
Katrina Mejia-Blom,
Dale Blom
City of Redondo Beach
State of California
United States of America.

Read the story here
More on it here.

It appears this Dr. Philip Megdal was the same dentist accused of negligence in the death of 4 year old Javier Villa, Jr. in 1998

More on Javier’s death.

Consumer Dental bought the Megdal clinics after Javier’s death

Monday, August 22, 2011

Penny v. OrthAlliance, Jordan v. OrthAlliance & Glower v OrthAlliance- Corporate Dentistry Ruled Illegal


From Hospital and Health Systems Group – June 2008

One example of provider relations going horribly wrong is the OrthAlliance experience. OrthAlliance is an orthodontic practice management company that follows a model common in the industry: the company first purchases the assets and leaseholds held by individual orthodontists or professional orthodontic corporations; then it enters into an agreement with the orthodontist or practice to
provide comprehensive practice management services; and finally, the practice
management company employs the orthodontist’s existing nonprofessional staff. It appears, however, that the arrangements were not as financially successful as several of OrthAlliance’s orthodontists had hoped, and the relationships between OrthAlliance and many of those providers eventually broke down. By 2001, approximatelyfifty-six OrthAlliance-affiliated practitioners and/or  their professional corporations had filed lawsuits in eleven states.


2003 Penny v OrthAlliance
Corporate Dentistry Ruled Illegal

From Orthalliance 10-k Annual Report

On March 26, 2003, the U.S. District Court for the Northern District of Texas, in ruling on the plaintiffs’ motion for summary judgment in a case captioned Penny v. OrthAlliance, Inc. , held that, when construed together, the purchase agreements and service agreements between the plaintiffs and OrthAlliance and the employment agreements between the individual plaintiffs and their practices violated Texas statutes prohibiting the unauthorized practice of dentistry and were therefore invalid. In the court’s view, the interrelationship among these agreements allowed OrthAlliance to own, maintain or operate an office or place of business in which it employs or engages the plaintiffs to practice dentistry, in violation of Texas law. In reaching its conclusion, the court noted that OrthAlliance leases or owns and maintains the office space and tangible assets used in the plaintiffs’ practices and provides comprehensive practice