Wednesday, June 25, 2008

New Small Smiles Papoose Board Consent


In FORBA/Small Smiles' Policy and Procedure Manual the consent for papoose use (stabilization) it said there was "no know risk to the immobilization procedure". It's evident FORBA/Small Smiles knows that is an out right lie since they are now using another consent form, I'll explain:

Recently another consent agreement says otherwise.

When you look at the form, at the lower right corner it says it was updated 1/31/2008, however it sure wasn't the consent form handed to me as part of the initial paperwork prior to treatment at Small Smiles just one month ago. (May 2008)

I asked myself why this particular form has now surfaced in at least two clinics that I'm aware of then it hit me. It's being used at those clinics who have been/are under the media microscope, but I'm wondering if it's being used in ALL clinics.

So, for all those employees who visit here regularly shoot me a line and let me know if this is the form you are using in your clinics. Email Me

Click here to see the Consent Form that has been updated. In this one, at the bottom, it will tell you that using it could cause death to your child among a host of other things that no parent would want to happen to their child.

To compare them, here is a link to see the consent I was handed in May 2008.


Monday, June 23, 2008

Small Smiles Denial Of Owning Clinics In Kansas Debunked

This is a repost from March 2008

The Wichita Eagle

March 15, 2008

  • Original The Wichita Eagle article:

A Wichita dental clinic that serves mostly low-income children is drawing criticism from some parents and other dentists, in part for using procedures that the critics say traumatize its young patients.

They say Small Smiles Dental Clinic of Wichita routinely restrains children during treatment, does not allow parents to accompany their children to treatment and does work that doesn't seem necessary.

In addition, the dentists are concerned that Small Smiles tries to give the impression it is staffed by dentists who are specialists in children's care. And, they say, it is corporate dentistry, a practice not allowed in Kansas.

Small Smiles dentist Reza Akbar, in an e-mailed statement, said, 'We are proud of the high-quality, compassionate care we provide.... Last year, we served more than 11,000 children, and the feedback I have received has been overwhelmingly positive. I am unaware of any concerns raised by parents.'

Akbar is the owner of the clinic, according to a Small Smiles spokesman.

Small Smiles, which opened in 2005, turned down requests for interviews or visits. An out-of-state spokesman for Small Smiles, who asked not to be named, said by e-mail, 'This is a concerted effort by the company to focus on patient care in the midst of recent scrutiny.'

In November, ABC News and an affiliate ran stories about Small Smiles offices in the Washington, D.C., area. The stories told of frightened children, the use of restraints and the prohibition of parents in the treatment area -- the same concerns echoed by parents and dentists in Wichita in interviews with The Eagle.

Many Medicaid clients

Small Smiles' advertising notes that it serves Medicaid and HealthWave children. The Small Smiles spokesman said 98 percent of Small Smiles' Wichita patients have Medicaid or HealthWave, programs that provide medical and dental coverage for low-income children and some others who meet income guidelines.

Many dentists do not accept Medicaid patients or accept only a few because the reimbursement for their care is less than what is paid by private insurance. But Crystal Walker, a pediatric dentist, said four of the five pediatric dental practices in Wichita do accept Medicaid patients. Some general dentists also take those patients, and dental care is offered to Medicaid patients at GraceMed and some other clinics.

In 2007, Small Smiles got more than $4.5 million in Medicaid and HealthWave dental payments from the state, according to the Kansas Health Policy Authority. The clinic declined to say how many dentists it employs.

The clinic uses what amounts to assembly-line dentistry, some say.

'They go in, they do the cleaning, they do the diagnostic, they get everything done that they can in one day,' said pediatric dentist David Brown.

'It was like an assembly line,' said Shelbi Meisch, whose daughter was a Small Smiles patient. 'There was just nothing about the experience that felt like you were getting good care.'

Restraining patients

Though parents said they were not allowed to accompany their children into the treatment area, the Small Smiles spokesman said that's not policy: 'Parents decide in consultation with their dentist whether or not to be present during their child's care,' his e-mail said.

Jeff Davis said he and his wife were asked to sign a consent form giving Small Smiles permission 'to do everything from yell at the child to physically restrain them to tie them down.'

Meisch, as well as Delicia Akbar, whose children also were Small Smiles patients, said uncooperative children -- including theirs -- are immobilized in a 'papoose board.' Akbar isn't related to the Small Smiles dentist.

The Small Smiles spokesman provided a copy of a consent form used at Small Smiles in Rochester, N.Y., and said the one in Wichita is similar.

It asks parents to agree to 'protective stabilization,' described this way: 'The child is wrapped in the device and placed in a reclined dental chair.' Pictures on the form show a child with what looks like a blanket and a shaped back piece.

Medical suppliers describe a 'papoose board' as a rigid board with wide fabric straps that have Velcro fasteners. Separate straps hold limbs inside the wrap, providing a snug-fitting restraint that immobilizes the patient.

The Small Smiles spokesman said, 'Our records indicate that protective restraint was used in fewer than 3 percent of all patient visits in Wichita last year.'

Akbar took her three children to Small Smiles. She read and signed the consent form 'but my understanding of the restraint was not something.. to strap them down.' She said the papoose board was used on her 9-year-old.

'I didn't even think anything negative until the kids came out

Copyright © 2008 The Wichita Eagle, All Rights Reserved.

____________________________________________________________________________

Thanks to a heads up from one of my readers, here is an article where Mike DeRose admits they own and operate clinics in Kansas:

Gazette, The (Colorado Springs), May 9, 2004 by CARY LEIDER VOGRIN THE GAZETTE

Dr. Michael DeRose describes himself as "just a simple little Pueblo kid that wanted to help poor kids."

DeRose, 47, is a third-generation dentist, following in his grandfather's and father's footsteps.

Bruno DeRose graduated from dental school in 1928; Edward DeRose started practicing in 1961. Michael DeRose went to dental school at his father's alma mater, Creighton University in Omaha, Neb., returning to his hometown to practice in 1982.

Michael DeRose said his dad had the heart to treat low-income children, explaining how the family got into the Medicaid business.

"He opened his doors for every patient," he said.

He and his father practiced together and became known to kids around Pueblo as "Spaghetti Eddie and Meatball Mike" because of their Italian heritage, DeRose said. Business grew when they opened a second clinic in Colorado Springs in 1995.

The DeRoses have built something of a dental dynasty, having a financial stake in clinics in eight states: Colorado, New Mexico, Arizona, Indiana, South Carolina, North Carolina, Georgia and Kansas.

"It's really a family-owned business with Dr. (William) Mueller," he said, referring to a Denver dentist who has a financial interest in some clinics.

DeRose said his brother, Dan, provides marketing and management services, and an uncle, Adolph Padula, has a financial interest in some clinics. Neither responded to a request for an interview. Mueller did not respond to a registered letter sent by The Gazette.

The clinics have done well. Michael DeRose bought a home last year in Pueblo West overlooking Lake Pueblo for $3.4 million -- a record price in Pueblo County for what the Assessor's Office terms "a nonagricultural based residence."

The family has a stake in 21 clinics across the nation staffed by about 70 dentists, according to Michael DeRose. Dental offices most recently were opened in Kansas City, Kan., and Florence, S.C., he said.

Plans are under way for expansion.

"We think that there's more places in Georgia that could really use our help," DeRose said. "We've looked at Oklahoma as a consideration. They have a lot of need in the Oklahoma City area, maybe Tulsa."

The clinics are "well-received" because they fill a need, DeRose said.

Small Smiles in Colorado Springs, for example, is in an area where 26 percent of people age 17 and younger live in poverty, according to census statistics.

"There is an epidemic in the United States, and it's hard to believe we can put a man on the moon and yet there are thousands and thousands of poor children that cannot find dental treatment," DeRose said.

It's common at his clinics, he said, to see children with severe decay.

During an interview at the Pueblo clinic, DeRose offered a tour. Treatment rooms are painted with kids in mind: There's a blue- andorange "Broncos" room and another with an "Austin Powers" theme. For younger children, rooms are decked out with "Scooby Doo" and "Blue's Clues."

The dentists go by kid-friendly names, wearing shirts that read "Dr. Mike" and "Dr. Nate."

Edward DeRose is retired from practice but still has a large office at the Pueblo clinic.

Michael DeRose said business has "grown beyond our dreams," but money isn't the motivator.

"Sure, business, if you can make money at it, that's great," he said. "But when it's dual purpose and you can make money yet help people -- that's the best thing you can do."

DeRose said he's had no problems finding dentists for his clinics.

"There's a lot of dentists that have the heart to treat poor children. A lot of doctors really would like to do this but they just feel like they can't make money at it," he said. "We can provide them an opportunity to do something that's their dream. It's the best of both worlds.

"There really is something to be said about sleeping good at night." (I bet he's not sleeping so well at night right now.)

Copyright 2004
Provided by ProQuest Information and Learning Company. All rights Reserved.

____________________________________________________________________________

I have already posted on this blog the campaign contributions that Dr. Mohammad Reza Akbar, of Pueblo, CO had made to a Kansas politician in the name of Small Smiles.

Plus if you guys could see an in-house company directory you would see the Small Smiles in Kansas listed as part of the company.

So Kansas, is corporate dentistry like this now legal or are they going to be shut down. It's not like Small Smiles accidentally opened up these clinics. They blatantly broke your laws with intent to defraud your medicaid system.

Sunday, June 22, 2008

Small Smiles in Chapel Hill, NC

This add came from UNC Dental Alumni Associations Website. Click Here

Name: Small Smiles Dentistry
Owner: Private
Location: Chapel Hill, NC

Job Description:
Small Smiles Dentistry SEEKING DENTISTS to join our great staff. Rewarding work environment with state-of-the-art equipment. We are the nation's largest and most experienced provider to underserved children and young adults with 70 locations.

Contact:
Jenna Kochenberger
415 N Grand Ave
Pueblo, CO 81003
Phone: 7195624462
Fax: 7195847696
Email: jlkochenberger@smallsmiles.com

WOW, now this is an interesting ad.

First: (to get this out of the way) Wasn't the last contact person Jacob D. Kochenberger in the ads at aftercollege.com. I just can't say it enough when I say FORBA (Michael DeRose) sure keeps it all in the family, I wonder if Jenna and Jacob (sounds like brother and sister doesn't it) are more cousins like Brad Padula.

I also notice that the address is DD Marketing's address in Pueblo. Oh, that infamous 415 N. Grand Ave, that crops up as the address for all sorts of DeRose businesses.

Second: Let's get this out of the way, I sure wish they would stop using the word underserved as one word. I know I make a lot of typo, leave of a lot of 'ing's and 'ed's etc but dog gone it, I just wish they would say they serve "under served" and not 'underserved'.

Third: FORBA (Michael DeRose) has gone to great lengths saying he's basically out of the state of North Carolina. (ran out on a rail pretty much). He says he sold SmileStarters to Raf Rivera and it's under new management. (Yeah, Right! Managed by Root Dental Management, who is DeRose's accountant! Plus who loaned Raf Rivera that kind of money to purchase clinics who were just fined 10 million dollars and headed down the tubes, well one Michael DeRose would be my guess.

But look, North Carolina, he's baaaaack! Him and FORBA are right back dipping their lilies right back into Medicaid pot of gold. Who manages your dental medicaid service anyway? Dumb and Dumber?

Sounds just like Tish Ballance sticking her grubby little fingers back in with her Access West Clinic is Asheville doesn't it. (I guess she's still opening that clinic, I've not heard otherwise)

What's it going to take to shut these criminals out of North Carolina anyway?

What are you going to do this time! Monitor them some more! A lot of good that does!

Conflict of Interest at Department of Medical Assistance Services-Virginia

I just find it totally amazing that Dr. David Strange of Kool Smiles is on the Dental Advisory Committee of the Virginia Department of Medical Assistance Services. He may have a licenses there but I bet you he's never touched a patients mouth in Virginia, yet he wants to be an adviser!! What is he planning to give advise them about.

It's that like the fox watching the hen house. He is in business with Dr. Tu M. Tran and Dr. Theim Pham who originally trained and worked with Drs. Michael and Ed DeRose at Smile High Clinic which morphed into Small Smiles. Want to take a guess where Tran, Pham, and Strange are from, Colorado!

Not only this, but Dr. Harry M. Joseph is an employee of both Small Smiles and Kool Smiles according to Doral's May 2008 Handbook, so what gives with that.

I think there is a clear conflict of interest here!

Dental Advisory Committee Members (updated) 2008

Dr. David Strange (from the Kool Smiles website)

Dr. David M. Strange, Chief Dental Officer
Dr. David M Strange is a board certified pediatric dentist. He received his Doctor of Dental Surgery degree from the University of Colorado Health Sciences Center along with his certificate of Pediatric Dentistry from the Children's Medical Center in Dallas, TX and his MS from the Baylor College of Dentistry. Dr Strange was formerly an Associate Clinical Professor at the University of Colorado Health Sciences Center and also served as the President of the Colorado Academy of Pediatric Dentistry. He previously served on the Constitution and By-Laws Committee of the American Academy of Pediatric Dentistry and is currently serving on the Council for Dental Benefits of the American Academy of Pediatric Dentistry. Dr Strange is also a member in good standing with the American Dental Association, the American Academy of Pediatric Dentistry, the Colorado Academy of Pediatric Dentistry, the Georgia Dental Association and the Southwestern Society of Pediatric Dentistry. His three children and wife live in Atlanta after relocating from Denver, Colorado.

Saturday, June 21, 2008

United Health Care Removed Dental Search from Website

On 6-17-2008 I was able to go to United Health site and visit this page

https://www.myuhcdental.com/presence/release/MemberDentistList.asp

or here and choose a state plan and search for a dentist who accepts medicaid. They would tell me the clinic name, Small Smiles for example as well as the name of the dentist at that clinic.

By the next day I could still go there but each and every search for a dentist under any plan and any search criteria would end up with zero results. The first time I did it, heck I could even get the list emailed to me. Now you can't find a recommended dentist from United Health to save your soul.

So I have to ask why that is.

1. They don't want the public to know they are recommending it's members to visit Small Smiles.
2. They are protecting themselves from lawsuits because they continue to recommend it's members take their children to Small Smiles even though Doral Dental has suspended them, in several places anyway, or
3. The dentists they listed as being employees of Small Smiles threw a fit because they are so embarrassed of being associated with Small Smiles. (let me say here I know this to be true from the emails I received...)

Anyway I'm glad I had my lists emailed to me and they came from the following email address:
dentalproviderlist@yourdentalplan.com

The subject was: Custom Dental Provider Directory List

I don't know who's cheatin' who here, but there are some really embarrassed people out there because of their association with Small Smiles, including major HMOs.




Kool Smiles, Small Smiles & Smile Starter Jobs Openings

There are still job openings at Kool Smiles, Small Smiles and Smile Starters but they are not as abundant as they were just a few weeks ago. Not surprising since I'm sure there is a 'hiring freeze' due to the fact they are all financially stressed. But here is what I found after a bit of digging.

Kool Smiles Job Ad:

Kool Smiles is currently is looking for FT general dentists to join us
in AZ, AR,GA, IN, MA, MS, KS, KY, SC, TX and VA. Our offices are brand
new and equipped with state of the art technology such as digital x-rays
and electronic dental records. Hands on training provided by pediatric
dentists! Kool Smiles offers: $100 - 120K base compensation for new
graduates
, experienced dentists’ salary is negotiable. Bonus potential
of up to $70K
, health insurance, dental insurance, malpractice
insurance, paid vacation, paid holidays, continuing education, long term
disability/short term disability, and much more! The ideal dentist will
enjoy working with kids. For a fun and rewarding place to work, please
contact Andrea Jett at (770) 916-5023 or email your CV to
ajett@ncdrllc.com.

__________________________

Small Smiles Jobs ad: (aftercollege.com) 32 job locations see here

Base pay is from $120000.00 to $200000.00 per Year

SEEKING ASSOCIATE & CHIEF DENTISTS to join our great staff. Rewarding work environment with state-of-the-art equipment. Our practices are improving access to care and making a great difference in the communities we serve. We currently have positions available in:
Youngstown, OH
Dothan, AL
Montgomery, AL
Augusta, GA
Savannah, GA
Greenville, SC
Columbia, SC
Hartford, CT
Lawrence, MA
Manchester, NH
Rochester, NY -I thought there weren't accepting patients, since medicaid shut them out in NY
Wichita, KS WHAT?!- they aren't even supposed to have clinics there.
Topeka, KS WHAT?! ditto
Oklahoma City, OK
Tulsa, OK
Baltimore, MD HUH?
Albuquerque, NM
Santa Fe, NM
Denver, CO
Colorado Springs, CO
Pueblo, CO
As the nation's largest and most experienced provider to under served children and young adults we offer an excellent guaranteed base salary, promotion opportunities and benefits (including monthly bonus potential, 401(k) with company match, paid vacation & holidays and 100% coverage for health insurance, malpractice insurance, disability insurance, continuing education, dues and fees). Relocation reimbursement offered and licensing assistance provided.
Join our team of professionals providing quality dental care. General Dentists, Pediatric Dentists and new graduates are encouraged to apply.
Please send resume to Jacob at jdkochenberger@smallsmiles.com or call 719-562-4460. (That's Jacob D. Kochenberger of Pueblo, CO) Michael G. Lindley, Nashville, TN is the CEO of FORBA

______________________________________

Tish Ballance's Access West Job ads:

They have virtually disappeared from the Internet! Just a few weeks ago if you googled Tish Ballance she had job postings everywhere.

_______________________________________

Smile Starters Job ads:

6-8-08

North Carolina - Smile Starters is looking for a few Good Dentists!! We are seeking a few highly motivated professionals to join our team of dedicated, caring dentists providing quality dental care and increasing access to care for underprivileged children and young adults. SmileStarters are dentist owned and operated, general dental practices located throughout North Carolina. We currently have established practices in Charlotte, Winston Salem. Raleigh, Greensboro, Fayetteville and Asheville. If you desire a rewarding career in a modern, team-oriented, positive environment and a need to make a real difference, then SmileStarters may be the place for you. We offer excellent guaranteed salaries beginning at $144,000 and comprehensive benefits including health, life, disability, and malpractice insurance, paid vacations and holidays, 401K plan, CE time and fees and much more. and up to a $5,000 signing bonus available at select clinics please contact Roger Walters- Root Dental Management at 704-395-6000 or by email at walters.rdm@gmail.com. Come help us to make a difference "A-Smile-At-A-Time". New grads are encouraged to apply, a great place to begin your career!!!

Friday, June 20, 2008

List of Dentists Working for Small Smiles and Kool Smiles as of May 2008.

Want the current List (May 2008) of Dentists who are employed with Small Smiles or Kool Smiles in the Virginia, Maryland, DC area? You can find it right here. It's Doral Dental May 2008 Virginia Smile provider handbook.

When it opens, just look at the top menu bar where it says "Find" type in Small Smiles or Kool Smiles and hit enter. There should be two little page icons that show up after that, just hit the one on the right and it will look for the word Small Smiles as it appears next in the document and so forth.

Looks like Dr. Harry M. Joseph swings both ways. He was (swinging both ways) in September 2007 as well.

Virginia, Maryland and DC Dental Salaries for Small Smiles and Kool Smiles

I obtained a print out of the number of dentist employed with Small Smiles and Kool Smiles in Virginia, Maryland and the DC area, here's the breakdown give or take 10 or so.

Small Smiles has about 30 dentists.
Kool Smiles has about 60 dentists.

I've seen ads on the Internet where Small Smiles has advertised a starting salary of $144,000 however it may be more like $125,000 at present. Ok, so that is a wage expense for dentists alone of (using the median, of $135, 000) $4,050,000.00 a year. Remember that is just dentists salaries.
Let's look at Kool Smiles and use the same salary, that is 8,100,000.00 a year in dentist wage expense alone.

$12.15 million between these two companies in one area in one year needed just to make dentist payroll! No wonder they have a quota to meet each day... (clearing throat, I mean "conversion rate" as they call it) No wonder they tie 'em up and rush them through. No wonder they get a bit creative in treatment. No wonder they've been caught in some questionable billing of Medicaid.


Just think of the number of filling, crowns, sealants, etc needed each year to make just those salaries alone, not counting all other supporting staff, office expenditures, advertising, countless attorneys, PR firms, Lobbyists, equipment, buildings and utilities, supplies and on and on.

Just imagine that for a minute. That is just in one small area of the county, that is just in 8 Small Smiles clinics and 12 Kool Smiles clinics.

Just think they have 90 dentists right now doing all they can to make those dollars roll in.


Small Smiles Update from Roberta Baskin 6-16-2008

6-16-2008
arrow WJLA TV's I-Team Reporter, Roberta Baskin, has an update on her Small Smiles Investigation:


-WJLA SCRIPT-

ANCHOR:
TONIGHT FROM THE ABC 7 I-TEAM, DRAMATIC NEW DEVELOPMENTS TRIGGERED BY OUR EXCLUSIVE SMALL SMILES INVESTIGATION OF THE NATION'S LARGEST PROVIDER OF DENTAL CARE FOR MEDICAID CHILDREN.

FOLLOWING OUR INVESTIGATION...MEDICAID AND SEVERAL PRIVATE INSURERS LAUNCHED THEIR OWN INVESTIGATIONS AND NOW, THEY'VE BEGUN TO TAKE ACTION.

THE I TEAM'S ROBERTA BASKIN IS HERE WITH MORE REACTION TO HER EXCLUSIVE REPORTS... ROBERTA?

ROBERTA BASKIN:
MEDICAID SUB-CONTRACTS TO THOSE PRIVATE INSURERS TO PROVIDE DENTAL CARE TO CHILDREN IN NEED. SMALL SMILES HAS BEEN THE BIG BENEFICIARY OF THAT ARRANGEMENT... UNTIL TODAY.

STORY:

The Small Smiles clinic in the District is turning away patients today and like the other four Small Smiles clinics in the area, cancelling most of its June appointments..

"Following audits by private insurance companies discovered hundreds of thousands of dollars in unnecessary dental work. One company reported finding "teeth may have been pulled unnecessarily."

This father doubts his 7 year old son's teeth needed the work Small Smiles recommended.

"He have good teeth so I don't know why they say, fill it up with something."


Doral Dental USA has now terminated four of the 20 Small Smiles dentists in our area from its network and suspended its GROUP practices pending further review.

Colette Phoenix: "I honestly didn't know that they were being audited or even investigated for this." "It does raise some concerns so I'll definitely check into it."

Neither Doral nor Small Smiles will tell us the names of those dentists and declined to be interviewed…but the suspensions affect thousands of families who receive dental care at the chain's five clinics in the district and Maryland.

"After today, you know, I am look into see if I can find another dental clinic for her to go to, for both of them to go to."

Health insurance providers tell us they are contacting families to find new dentists for them.

ROBERTA BASKIN-"Is it difficult for you to find a dentist?"

Mom: "Yeah, yeah, it's difficult."

Our investigation in November exposed callous treatment of children…separating them from parents…strapping them to papoose boards to increase productivity, performing unnecessary procedures, and using unlicensed x-ray technicians.
We also revealed how Small Smiles worked the taxpayer funded Medicaid system.


Dr. Aldred Williams: "They threw up the white flag and said, "Okay, you don't have to preauthorize anything. Just do the work. So we flooded the system."

Doral Dental had suspended Small Smiles for three months following our investigation but has told the state of Maryland is has discovered even more irregularities. It will be another 4-6 weeks for Doral to complete its investigation.

ROBERTA BASKIN IN STUDIO:

UNITED HEALTHCARE, ONE OF THE LARGER INSURANCE COMPANIES CONTINUES TO REFER FAMILIES TO SMALL SMILES DESPITE FINDING MORE THAN A QUARTER OF A MILLION DOLLARS IN QUESTIONABLE TREATMENTS.

MEANWHILE, THE MARYLAND ATTORNEY GENERAL'S OFFICE HAS A CRIMINAL INVESTIGATION UNDERWAY.

WE CONTINUE TO HEAR FROM PATIENTS AND EMPLOYEES FROM AROUND THE COUNTRY ABOUT PROBLEMS WITH SMALL SMILES. KEEP CALLING AND GO TO OUR WEB SITE FOR LINKS AND RESOURCES:

WWW.WJLA.COM.

Click here and go to the bottom of the page to see Doral's Statement, Small Smiles Statement and Small Smiles Audit and Suspensions.

Thursday, June 19, 2008

Small Smiles and Kool Smiles Dentists in Virginia and Surrounding Area

If you would like to see the list of Small Smiles and Kool Smiles Clinics including dentists names who were employed with these clinics as of September 2007 according to Doral Dental Member Handbook for the State of Virginia and Surrounding Area Click here.

There are hundreds of them. I think you will be shocked at the number of dentists associated with Kool Smiles alone. I certainly found it shocking to think there are that many dentists in just one area that could potentially harm and traumatize your children. Note that Dr. Tu Tran, Dr. Thein Pham, Dr. David Strange, Jr. and Dr. John Ambose are very busy dentist since they seem to treat patients at every clinic in every city.

Some dentist on the list posted earlier have written and told me they have left employment with Small Smiles and some have even filed complaints against them. If your name is on their provider list might I suggest you contact the appropriate people and have your name removed. Contact me as well and I will duly note that you are no longer employed with these companies.


Again, I can't stress enough if you are no longer with either of these companies please email me immediately. Clickable Email Me Link


Wednesday, June 18, 2008

New Papoose Board Consent Tactics Surface

Today I've received two separate reports from concerned parents that indicate FORBA-Small Smiles have changed it's tactics in obtaining consent to strap children down in papoose boards.  There reports are from two separate states. 

(Boy, the Papoose board sure is an important tool for these places aren't they)

Evidently they aren't having the parent or guardian pre-consent to the use of these devices anymore.  (They are calling them "protective wraps", isn't that sweet!)

From the two reports I've gotten just this morning, they are still separating the parents from the children, taking the children back for fillings, sealants, crowns whatever, then returning to to the parents saying:

"because he was wiggling and screaming and said that he was a danger to himself and the doctors"

It makes it seem that they are in the middle of a procedure and it's imperative they sign this consent so that they can finish the procedure.

Whatever the real reason, it's clear they have changed their tactics but still pushing on tying up children at any cost.

Now, FORBA, you want to make another statement about how you are improving things?  That is just pure BS!

Manama Al Manamah, Bahrain

June 18, 2008

Things must be really bugging the folks in Bahrain today.  Of course there is a major time zone difference but it's early here in the US, 10:30am or so and visitors from Bahrain have been here 6 times and that's very unusual. 

Something posted as really hit a cord with them I guess.  They are mostly interested in Roberta Baskin's latest  Small Smiles update.

My usual visitors are the mothers, parents, etc from children mistreated at Small Smiles and of course folks in Pueblo, Colorado; Nashville, TN; Colorado Springs, CO.  Visitors from Washington DC are also big visitors, as well as North Carolina and New York state, Maryland and Virginia. 

So when Manama Al Manamah (The Capitol of Bahrain) Bahrain shows up in my stats I know something is up.

Is this Small Smiles-FORBA thing going to end up turning into an International Incident?

Tuesday, June 17, 2008

Open Questions to FORBA-Small Smiles Management

Are you all just sick to death of the standardized statements from FORBA-Small Smiles saying they are doing everything in their power to address the problems brought to the publics attention in November 2007.
Honestly, it's not like FORBA didn't know all these things were going on, they were just confident the public wouldn't find out to what extent it was happening. FORBA-Small Smiles were/are making millions and millions of dollars and have for years doing this crap.
But since they keep making these stupid statements, I want to know exactly what they are doing, working on, improving or whatever term they are using today. Stop with the general statements and tell us exactly what you've done other than hire a papoose board expert.
Here are some other hard questions for you to answer, since the DOJ is questioning your current and former employees and criminal investigation are going on in several states something tells me you are going to be asked these questions by them pretty soon anyway so why not just bite the bullet and get it over with right here.
  • Do you still have papoose boards or pediwraps in your clinics? yes or no
You don't even need one, but people would accept having one in each office for use in case of emergencies. I' assuming each offices has as many now as they did back when this story broke since ebay isn't flooded with the things. Honestly you say you've been trying to address issues since November, how long does it take to dispose of these things anyway?
  • Are you still billing for things you didn't do or were not necessary? yes or no
As late as March 31, of this year, you told a mother you didn't tie her child up to a papoose board, but as I have shown you on the site, you entered a service code for 'behavioral management' which we all know means you tied the child up.
  • Are you supporting employees who complain about the dentists you employee who are mistreating children. yes or no
A few short weeks ago you fired an employee who complained about a dentist mistreating a disabled child. In another case you have told employees they may need to get their own attorney to represent them when speaking with the Department of Justice and State Inspector Generals.
  • Are children still leaving your clinics injured? yes or no
In April a 3 year old left one of your Smile Starter Clinics with a bloody nose. I could list even more if you like.
  • Do you still have a quota to meet each day, even though you now call them conversions, where you want so many children sent from the hygiene (cleaning) area to the operatory for some fillings, sealants or crowns? yes or no
According to employees, that answer is yes so be careful when answering this question.
  • Do you keep combs, brushes, hair blow dryers to use to clean children up after being "treated" (and I use that word loosely) before you take them back to the parents? yes or no
Careful answering this one too, as I have pictures of these items located in one of your clinics.
  • Are you now encouraging parents to come back with their children for treatment? yes or no
We know the answer to that one too don't we. You've done nothing to support parents being allowed back with their children. You should be dragging parents back there, even if they are the ones kicking and screaming but you are not.
  • Isn't it true that Michael DeRose and other family members are indeed receiving compensation out of the Small Smiles bank account? yes or no
Acaptia and CIT say they are invested with "current upper management", DeRose say's he has nothing to do with FORBA-Small Smiles.
  • Isn't it true that Michael DeRose is the backer of Dr. Raf Rivera in his so called purchase of Smile Starters, which in reality is still Michael DeRose stilling owning ever sticking bit of these brutal clinics? yes or no
  • Isn't it true that Root Management, the new management company of Smile Starter is operated by Ryan Root, a close friend and accountant of the DeRose clan of clinics? yes or no
  • Isn't it true that the clinics in Kansas are really owned and operated by FORBA-Small Smiles and not individually owned by private dentist? yes or no
I have a copy of the company directory that says they are clinics owned and operated by FORBA and in fact you refer clients who are moving to those clinics.
  • Isn't it true that you every time you get bad press you just change the name of your clinics and say they are under new management? yes or no
You just got into a world of crap in New Albany, NY and simply change the name to Albany Access Dentistry.
  • Isn't the Department of Justice investigating your clinics nationwide? yes or no
This is not happening for no reason now is it?
  • Haven't millions and millions of dollars been ripped off from the American People just to line the pockets of Michael and Ed DeRose? yes or no
I've posted picture of you homes, business and other news reports showing you guys have made a nice living "drilling for dollars"
  • Isn't it true that you have hired Lobbyist on the Federal and State levels to assist you in obtaining a larger piece of the medicaid dental payment pie? yes or no
Guys, you think these questions are hard, this is a tiny sample of what is yet to come.

Doral Dental Sending Patients to Small Smiles Across The Nation

Click here
Click Detail Search
Click the Search button beside Office Name
Enter Small Smiles, Kool Smiles, Ocean Dental and just about any state and click search.

What you will find is that Doral Dental is a major "pusher" "enabler" of these rogue dental chains.

Millions must be being made to keep all these hands in the cookie jar full of cash.

Think about it:

Medicaid Dollars pass to the subcontractors such as United Health and Doral Dental and all their stockholders and employees, then on down to Small Smiles/FORBA and all staff there, including investors such as CIT and Arcapita Bank, then they advertise they pay they working dentist $144k a year plus bonuses, and let's not forget the office staff, buildings, equipment etc. And let's not forget all the money the DeRoses have in their pockets, giving millions to Creighton University, living in multi-million dollar homes, etc. Then you have the lobbyist on the Federal Level, and just about every state level, several high powered law firms, and more than one huge PR firm.

Now that's a heck of a lot of money being made by strapping children on papoose boards and drilling away and any tooth they can get.

Heck this thing is so profitable their are other people opening up clinics everyday trying to cash in on the huge cash cow!

Is anyone out there gonna quit pushing these clinics and close their doors or not!

United Health Care Still Using Small Smiles: What The Hell Are They Thinking?

Despite Doral Dental, a sub-contractor for Maryland's Medicaid System, terminating 4 dentists and suspending Small Smiles for another 3 months for highly irregular and questionable practices, United Health Care, another sub-contractor doing business as Americhoice, finding more than $250,000 worth of "questionable treatments" will still send it's medicaid members to the following Small Smiles dental Clinics in Maryland for treatment.


  • GRIGORYAN, OVSANNA
SMALL SMILES OF LANGLEY PARK PC
GENERAL DENTISTRY
  • KING, TRACY S.
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • MILLS, LINISHA Y.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • PARIRENYATWA, SIMBARASHE
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • PARIRENYATWA, SIMBARASHE
SMALL SMILES OF BALTIMORE PC
GENERAL DENTISTRY
  • PFEUFFER, DAVID J.
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • ROBINSON-WARNER, GILLIAN A.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY

  • TOLER, KENYATTA M.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • TOLER, KENYATTA M.
SMALL SMILES OF LANGLEY PARK PC
GENERAL DENTISTRY
  • TYLER, DAWN L.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • UMEOZULU, OKEOMA N.
SMALL SMILES OF BALTIMORE PC
GENERAL DENTISTRY

In Washington DC they will gladly send you to:
  • MILLER, JULIAN P.
SMALL SMILES, PC
GENERAL DENTISTRY
  • MUNDEY, SHAKEYA
SMALL SMILES, PC
GENERAL DENTISTRY
  • STEPHENSON, KESHA J.
SMALL SMILES, PC
GENERAL DENTISTRY
  • VENIGALLA, LAKSHMI Informed They Are No Longer Employed With Small Smiles
SMALL SMILES, PC
GENERAL DENTISTRY

What the HELL is United Health Group thinking! Hopefully you are one of the lucky recipients of Doral Dental and won't be sent to any of the above dentists and your child will be spared the torture and abuse of unnecessary dental treatment and being tied to a papoose board just for the ease of it all.

I suggest if your linked up with United Health/Americhoice you exercise your American Choice and call, write or email United Health Group and demand better service for yourself and your children.

If you are a dentist and no longer associated with Small Smiles please email me, state when you left and I will note that you are no longer employed with Small Smiles.



Email Me

Update 9/9/2008

I received the following email and after weighting the request I decided there was no real benefit in not granting the request.

Dear Ms. Hagan/To Whom It May Concern:
As best as we are able to discern, the "Dentist the Menace" web site is maintained by a Debbie Hagan. This email is intended to reach all persons responsible for the content of the site.

This law firm represents Sanam Toufanian, D.D.S., whose name appears on the June 17, 2008, "Dentist the Menace" web site posting regarding Small Smiles entitled, "United Health Care Still Using Small Smiles: What the Hell Are They Thinking?". Dr. Toufanian no longer is employed with Small Smiles. During her employment at Small Smiles, Dr. Toufanian at all times acted in the best interests of her patients, and there is no allegation that Dr. Toufanian engaged in any improper conduct. Your web posting is false, misleading, and highly damaging to Dr. Toufanian's reputation. We therefore demand that you remove Dr. Toufanian's name from the June 17, 2008 posting immediately.

Sincerely,
Caroline Judge Mehta


Caroline  Mehta  202.778.1836 cmehta@zuckerman.com

Sunday, June 15, 2008

Mom upset with Small Smiles New Albany


Here is a case of a mother who took her child to Small Smiles New Albany in New York:
Since Small Smiles is no longer a Medicaid provider in New York one mother asked for her child’s records.
What she got were x-rays and nothing more than a spreadsheet of sorts, listing dates of visits, (every 6 months regularly), procedures, service codes for billing Medicaid, and initials of doctors who did the work.
Looking over the so called medical records (1 full year of them) a pattern clearly emerges.
The first visit, the child was give
1. Hygiene instruction: How much instruction do you think a three year old understood after all the parents are allowed back there. (was Medicaid billed for that as well or is that included in the cost of the visit?)
2. Fluoride
3. Exam
4. Cleaning
Exactly 6 months later the child returned, got the same as above with added x-rays and low and behold cavities were found because the next week the child was in for 3 filling! Three!! Wonder how they missed those on the first visit, or do you think the hygiene instruction wasn’t clear for the child to have gotten that many cavities in that short of time.
By the initials of the dentist, Dr. Laura did these fillings.
Another 6 months pass, more hygiene instruction, fluoride, exam, and cleaning and there again, they found another cavity. This time it was Dr. NL who did they work. All this doesn’t say much for Small Smiles “hygiene instruction now does it”.
Since Small Smiles tries to keep their torture clinics friendly they just use the first names of the doctors, Dr. Laura for example so this mother has no idea what the real name of the dentist actually could be.
What really concerned this particular parent is this:
  1. She was told they did NOT use a papoose board on her child. She asked since her child came out very upset and said the dentist was “mean”. Yet according to this “record” behavioral management” of some type was used and it appears billed Medicaid for doing so. So they are lying to someone, either they used the papoose board and lied to the mother or they billed Medicaid for something they didn’t do.
  2. She is also concerned, and rightfully so, that these records seem to be a bit incomplete to say the least! Where’s the notes taken during the exam there has to be more than a tiny spread sheet don’t you think!
This is not long ago people this is current stuff, so don’t by the sales job they are trying saying they are “improving” anything cause they aren’t improving anything.
I’m wondering if Small Smiles/Albany Access Dentistry even have this child’s original records, documents showing where this child’s mom signed consent for anything at all to be done, where is all this stuff, could be in a heap of shredded documents for all we know.
I’ve been at this for months with these people and I’m not seeing any improvement, even with the Fed’s snooping through the records across the county nothing is getting a bit better!


Full Size image here

Thursday, June 12, 2008

Michael DeRose Living "Two" Carefree

I'm telling ya, life is just so strange and at times just down right funny. We've all heard about "vanity license plates", but what about "omen addresses"?

I found that a one Michael A. DeRose lived at....

....get this....

....are you ready?

2 Carefree Lane

Pueblo, CO 81001

at ancestry.com records say he lived there in 1993 & 1994

That should have told him all this would come to an end one day cause he was living too carefree LMAO LMAO

Wednesday, June 11, 2008

Is Carolina Smiles a DeRose Clinic?

Today I noticed there is a dental clinic in North Carolina that accepts Medicaid called "Carolina Smiles". Now this wouldn't be odd if DeRose and FORBA didn't have clinics in Oklahoma called "Oklahoma Smiles" and the clinics in Texas called "Texas Smiles".

Now I'm not saying Carolina Smiles is another FORBA/DeRose clinic, I'm just saying the name is following they usual names.

Small Smiles New Albany Has Changed It's Name: Surprise Surprise

A month or so ago if you rang up Small Smiles in New Albany you would get the "Hello, Small Smiles" when the phone was answered. Then a couple of weeks ago that dropped to "Dental Office" we now it's "Albany Access Dentistry".

Looks like FORBA and Michael DeRose and Company have not learned any new techniques to cover their butts. Again, they just change then name, don't bother with changing the phone numbers or address, just slap a new name on the door, keep the same employees and go on about their business.

BEWARE, New York the name has changed but that's about it.

Does that word "Access" ring any bells with my readers, well it certainly rings a few of my bells.

Remember Tish Ballance in Asheville, NC who was fined 10 million dollars and was a business partner with Michael DeRose in the Smile Starters, Medicaid Dental Center and Carolina Dental Center, isn't her new state of the art clinic she's opening up in Asheville called "Access West"! Yep, I just checked, that's the name she's advertising!


Update:
Appears only a coincidence with the name "Access".  "Appears" being the operative word.  Tish went on to open Carolina West Dentistry in Waynesboro, NC under the business name of Ballancing Act.  In July 2010 she registered a business named CanHouse Sudios, it too in Waynesboro.  


Tish Ballance dose NOT live even close to Waynesboro ( or at least didn't two years ago).  She lives on the southern outskirts of Charlotte, NC about150 miles away.






Small Smiles Denying Some Parents Access To Medical Records

I'm getting a lot of email from parents who are having problems with Small Smiles handing over those medical records. You are entitled to a complete copy of those records. HIPPA laws have statues that cover this as well as many states have set their own standards. To the right in the Links section you will find a link to information and links to each states rules. Also in the download section is a sample letter for your use.



arrowarrowarrowIf you are denied access, you can file a complaint with the U.S. Department of Health and Human Service's Office of Civil Rights at:

U.S. Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C., 20201
Phone: (866) 627-7748
Web: www.hhs.gov


Sunday, June 08, 2008

DeRose Companies, LLC

DeRose Companies, LLC was formed by Mark DeRose and operates under the name of ServiceStar Development Company. See Here and Here

DeRose Family Federal Champaign Contributions

According to Newsmeat.com the DeRose family spread the contributions around but one stuck out in particular to me, that was Sen. Ken Salazar.

Out of all the federal campaign contributions listed for some reason the ones to Sen. Ken Salazar struck me as a bit odd. In most the other contributions they always donate to the republican party, however that's not the case with Sen. Ken Salazar.

See the list here

Sen. Salazar is on the Senate Committee on Finance:
...which has jurisdiction over tax policy (including the IRS), Social Security, Medicare and Medicaid, customs, trade agreements, general revenue sharing, and tariffs and import quotas. Senator Salazar is a member of the following subcommittees:
  • Energy, Natural Resources, and Infrastructure
  • Health Care
  • Taxation, IRS Oversight, and Long-Term Growth

Sunday, June 01, 2008

Forba Hires Donna Gilley. Now this is either to help them defraud more efficiently or help them hide what they've done a bit quicker. What is th

FORBA Dental Management Recruits Top Regulatory Expert as Chief Compliance Officer

Donna Gilley to lead regulatory complianceat nation’s largest dental practice management company focused on Medicaid and SCHIP Children
August 15, 2008 - Nashville, TN – FORBA, the nation’s largest dental practice management company focused on high-quality [laughable]dental care for underserved communities, today announced that Donna Gilley has joined the company as Chief Compliance Officer.
Gilley will report directly to Michael Lindley, FORBA’s Chairman and CEO, and will lead initiatives designed to ensure that FORBA-managed dental centers continue to comply with applicable federal and state laws and regulations, and cooperate with the agencies overseeing dental care for low-income children. [continue to comply...?? Oh dear God! They only want to see if there are other ways to screw the system!]
“FORBA’s mission includes a pledge to make certain that the centers we manage act as effective stewards of the public resources committed to children’s dental health,” said Lindley.
[Bull!]
“We have asked Ms. Gilley to lead our compliance unit and use her considerable experience and skills to ensure that FORBA-managed dental centers continue to meet and exceed applicable federal and state standards and provide high-quality care.”
[ I hope Ms. Gilley is ready to call her career quits, because not a soul I know so far has ever come to Forba or any of it's dental clinic and been able to leave with much of a career, most try to hide the damn fact they ever worked there for heavens sake!]
[Now they have a papoose board expert and a compliance expert on board, I can see they are gearing up for even more abuse and fraud]
Gilley, who holds multiple certifications in healthcare compliance, joins FORBA from LBMC Health Group, LLC, a Nashville-based consulting firm that has managed administrative, financial and compliance initiatives for major hospitals, healthcare systems and providers in Tennessee and across the southeastern United States. With more than 15 years of industry experience, her expertise includes Medicare, Medicaid and managed care regulatory compliance, payment methodologies and guidelines. She has also handled external compliance for multi-hospital, multi-state systems on matters related to HIPAA and other healthcare regulations, and is experienced in risk assessment, auditing, statistical sampling and other healthcare regulatory compliance activities.
Gilley has also held positions with TN Healthcare Solutions, Saint Thomas Health Services, and Columbia/HCA. She is a member of the Healthcare Financial Management Association, the Association of Certified Fraud Examiners, the American Health Lawyers Association, the Nashville Health Care Council; and is Co-Chair of the Health Care Compliance Association Southeast Planning Committee.
“I am excited about the opportunity to join a healthcare company that is serving the public interest,” said Gilley, “and I am proud to be part of a team that is working hard to help children from low-income families.”
[Woman you need to see a shrink!]

FORBA PR Machine At Work

After watching boards across the Internet for the last few days I can see FORBA-Small Smiles-DeRose have put the big PR firms to work but they are gaining little ground.

I swear I think they have actually hired people to spend their days getting out and making positive posts or try to find fault in what parents are finally speaking about.

The most common posts are:

1. We are trying to hire compassionate and quality staff. (How long does it take, they said that three years ago, two years ago, and last fall) They can't change a thing until they change to powers that be, and that hasn't even come close to happening. Those in power in 2000 are still there. It's clearly documented on this site with references that shows the same names of the same good ole boys at the same addresses.

2. It was an isolated incident. Whatever how many thousands of complaints for how long do they consider it to be a bit more than "isolated"

For Heavens Sake, the government set up a Hot Line to report abuse from these places!

Once again I can't stress enough that private dentists are doing this same crap. Be on alert!

3. Just a bad apple in the bunch. A bad APPLE!! Well, yeah! Lots of bad apples. When you set up shop in Pueblo Colorado and send out demon seeds across the country, to plant more diseased trees! Clearly some bad apples, from the bottom of the tree straight to the top!




DeRose, FORBA, Smile High Federal Court Filings

Michael A. DeRose, DDS filed for "Asset Protection" in Federal Bankruptcy Court 4-5-1999
Case number 99-01191

Smile High Dentistry filed Chapter 7 Bankruptcy 7-2-01
Case number 01-19589

There are also various other civil cases in Colorado, New Mexico and one that I found in Texas involving a dispute with DD Marketing vs. Grapevine-Colleyville Schools that was dismissed.

Again, these are just a few I found in a couple of hours of searching, I'm sure there are more, as always with these people.... there is always MORE!

Thursday, May 29, 2008

Small Smiles New York, Part 4

Senator Chuck Schumer calls for prosecution of these dentist. Read more below in the report from Albany's CBS channel 6 reporter Steve Flamisch.



Small Smiles, the children's dentistry clinic accused of mistreating its young patients in the pursuit of profit, lost its core patient base on Saturday.

The New York State Office of the Medicaid Inspector General terminated the Colonie clinic from the Medicaid program, eliminating its federal funding.



"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."

On April 1, CBS 6 News first reported the allegations of two former Small Smiles employees who claimed the dentists rush through procedures and perform unnecessary work in hopes of earning "production bonuses."


The company flatly denied the allegations, calling the report "a striking piece of substandard journalism." In the weeks that followed, however, more than 100 parents called or emailed CBS 6 to share their own Small Smiles horror stories.
The most common allegations included:
-Children receiving as many as eight crowns in a single sitting (all baby teeth)
-Work performed without the use of Novocain or any other numbing agent

-Dentists rushing through procedures, causing children to vomit and urinate themselves

-Children placed in a "papoose" restraint, regardless of whether it was needed

-Parents denied the option of sitting with their children during procedures


-Dirty instruments wiped-off and placed back in the drawer


Sen. Schumer, who has seen news reports documenting similar allegations against Small Smiles clinics in Denver, Rochester, and Washington D.C., bristled at the claims.


"They ought to prosecute some of the people who did this," he said 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."



State Attorney General Andrew Cuomo has the power to bring criminal charges against Small Smiles, and a trusted source confirmed that Cuomo's office is investigating.


In addition, the New York State Education Department, which licenses the dentists, has filed a subpoena requesting all of the information CBS 6 uncovered. The station is cooperating.



COMMUNITY HEALTH CENTERS
Though Small Smiles has now been stripped of its federal funding, Sen. Schumer said there are still safe and reliable alternatives for Medicaid parents: community health centers.
"Our community health centers have a good record," he said. "They're not like this company, they're on the up-and-up, and they often provide the best dental care for the kids who don't have any other way to get dental care."
There are three community health centers in the Capital Region:
Hometown Health
1044 State Street, Schenectady
518.374.8464
Whitney M. Young Jr. Health Services
920 Lark Drive, Albany
518.465.4771
Whitney M. Young Jr. Health Services
6 102nd Street, Troy
518.833.6900
Reader Comments:
1. As a practicing dentist in the Albany area I am both disgusted and yet not surprised at the revelations of goings on at Small Smiles. Dentistry is an art as well as a science. It is also a business. It is very expensive to provide good quality care. Typical overhead costs at a private dental office can be has high as 65-75%. Dentists who practice in such an environment, usually see one patient at a time, or devote a substantial amount of a patient's appointment time in direct care. Dental clinics, often advertise fast appointments, no appointments necessary, reduced fees, dentures in a day...I could go on and on. Bottom line, a typical dental clinic survives by producing as much dentistry as they can as fast as they can. In such an environment, something has to give. Sadly, in many instances
production, production is key to the success of said clinic. Production equals dollars and these dollars can be found either because the dentistry needed is really there or it can be "created" in order to meet production goals of both the individual associate working at the clinic or the clinic as a whole. Sadly, medicaid reimbursements for dental care in
NY State lag so far behind what it realistically costs today to provide said care that some providers "create" dentistry to be done. It appears that this is the case with Small Smiles. The big picture solution to this dilemma is to 1. bring realistic medicaid fee schedules to allow a dental procedure to stand on it's own, i.e. it is profitable for the dentist to provide 2. provide a better watch dog system to oversee that the care is being rendered is, in fact indicated and not simply created. There are dental clinics that operate profitably, ethically and in the best interests of their patients. Sadly, there are too many that don't and as a result the Dental Profession suffers and the general public becomes disenchanted with all the good things that modern dentistry can provide, ultimately hurting the very goal we devoted dental professionals hope to achieve...healthy teeth for a lifetime.

2. I am a mother of four kids and 2 of my 4 sons were going to Small Smiles. For all the time they were attending there I never was allowed in the back till one day when I did go there I seen a family member who said she goes and watches through there glass windows. I said you can do that she said,"NO, but I do". I had no idea these things were going on there. In March he needed a filling for a cavity on a tooth that holds one of his braces and when I took him there he was scared because he was told at the prior appointment that he might need a root canal if the cavity was to deep. First off they had no idea how far the cavity was because you can not take x-rays with braces because all you end up seeing is metal reflections in the pictures. At his March appointment I ended up going back in the room for the first time and I watched and observed things I did not like and realized HEY THAT IS NOT RIGHT. I watched this employee take the tweezers to open all the jars on the counter to get the supplies and then whip off the tweezer with a dry gauze pad. He placed it in the drawer and proceeded to get supplies He pulled out other metals instruments and they were not wrapped like most dentist have them. They asked which flavor gas mask my son wanted and he said a flavor and the Doctor said OH there is a Orange one use that one since it is out. My son did not want that flavor. The doctor proceeded to do his numbing using a needle which now makes me wonder was that clean. He said to my son this will pinch a little. They had him hooked up to the heart rate monitor and I watch as hmy son was scared his heart rate rise but not over 200 or anything. He began to tear up cause the doctor was using a longer needle than he used before according to my son. With braces I know he is already a sensitive person. I told him to hold still as it is almost done. The doctor sat and waited for the meds to kick in during that time noit once did he wash his hands in my sight. He had no gloves on and was wiping his nose and the put on gl;oves never washed his hands or wrists before putting the gloves on. The doctor proceeded with the the work and was drilling and drilling. My son tensed up and started to cry I stood up to hold on to my son and all the doctor kept saying was just a little more just a little more. I have no idea if he needed to drill as deep as he did as he had no xrays to go by. His assistant in the room was a male who acted like a female and had his hands and arm over my sons stomach and kept saying hold on sweetie or hold on baby. My son was uncomfortable at that point also. The time he spent drilling was almost 30 minutes and my son had a red face which was from the tight mask band and crying never allowed him take a rest in between the crying and being upset. When we finally were done he was sore and puffy around his cheeks and lips and very red from crying. When we were going to our car my son said,"MOM was that guy gay because I felt funny when he kept saying what he said to me." He had a hard time eating for 2 days after and remained sore. After this appointment it was less than 2 weeks when wrgb first aired about the story which made me realize that my son was treated like that also. I called my cousin and told her about the news and said "My sons will not be going there every again." I am sorry I put my kids through the HELL they did and I hope they will be able to not be afraid of another dentist again.

3. I am a father of three children that have been patients of Small Smiles and my youngest son which is 4 now but when he was 1 i took him there the dentist capped his four front teeth and when they spoke to me they never told me that they were going to have to cut his upper gums to cap his teeth they told me they can save the teeth by capping them but what happened was the caps rotted his teeth and some fell out and every time they fell out i called there and they told me to come in and they can reglue them back in. My other son that is 11 was taking there and they put crowns on his 2 back teeth and when i asked why they told me it was so they would not get cavities in them. When my youngest son went to the dentist for fillings they put silver filling when i was told they were going to use white and where they get the fillings from the plastic draw on the counter it is wide open the fillings are not covered. When my daughter got work done they numbed her but she still felt it and when she told them it still hurts they continued to finish with out renumbing her. I never recieved a invoice of any type just anoter appointment card.I believe the reason they give the children goodie bags after each appointment is so the childern try to forget what they have done to them. But this is something that a child will never forget. I don't think it is right that when you want to go in with your child and they tell you that you can only if you think your child is going to fight with them doing the work. My youngest son was there and i don't think it was nessary that the restraint blanket was used for him at that time it only scared him more. He came out and told me that he doesn't like it there anymore. Thank you CBS6 for letting all parents know the pain that there children are going through behind closed doors.

Wednesday, May 28, 2008

Your Tax Dollars Are Paying Dentist To Torture Our Children

That's right, your tax dollars are paying for these ruthless dentists to use straight jackets to abuse our children for non-emergency dental care.

In May of 2004 9NEWS Investigative Reporter Deborah Sherman began a series of reports on the treatment of children at a chain of dental clinics in Colorado and across the country. These reports have lead to changes in Colorado state law and prompted investigations in a half-a-dozen states.


In the first part of her investigation called "Papoose Boards" that aired on April 29, 2004, Investigative Reporter Deborah Sherman reported that some parents filed police reports after their children left dentist offices with scrapes and bruises.

These are the same clinics that 9NEWS reported had been hiring dentists not licensed in Colorado to work on some of the state's poorest children.

Children like Adrian and his brother Daniel, Dakota and her brother Chris, Cecilia , Alexis and Angelica.

All of their parents say the children were traumatized by a trip to the dentist.

"She actually threw up on me," said Tamera Elliott, mother of 2-year-old Cecilia. "She was just terrified of going back there."

Lucia Nevarez said her son Alexis, "went in crying and came out crying."

The moms took their kids to the "Medicaid Dental Clinic" in Aurora or "Children's Dental Clinic" in Thornton. That's where Catherine Richardson says both of her kids left with bruises.

"It was about the size of a half dollar," Richardson said as she pointed to the spot above her 2-year-old daughter's eye.

Richardson says Dakota was bruised on her head. She says her five-year-old son Chris had a bruise on his wrist when his arms were tied down in the dentist's chair.

9NEWS learned the children were put in restraint devices called papoose boards; unable to move their arms, legs and heads while dentists worked on or cleaned their teeth.

Some of the children were restrained for more than an hour.

Beatrice Ponce says her two boys came out very scared.

"Their mouths were swollen from all the work and full of blisters. Their foreheads blistered up and peeled."

The moms say they were told the clinic might use restraints on their kids and they might get red marks.

But the moms say they didn't realize the extent of what was going on because they weren't allowed in the exam room.

"What goes on back there?" asked Catherine Richardson.

"It scares me, you know? These are my babies and nobody can go back there with them."

The Aurora and Thornton clinics were co-owned by Drs. William Mueller of Denver and Michael Derose, DDS (Kansas Disciplinary Action Against Michael Derose, here) and Ed Derose of Pueblo. [side note: evidently from document at the Kansas Dental Board, Michael DeRose, DDS had been sanctioned in North Carolina in December 2005. In Sept. 2006, the Kansas Dental Board took action to enforce the North Carolina Order and another hearing is set for December 2008 to see that all conditions of his probation are met. North Carolina ordered him to show and demonstrate the use of a papoose board prior to strapping any child in one.)

The Deroses also owned three other dental clinics in Colorado: Smile High Dentistry in Denver, Small Smiles Dentistry in Colorado Springs and Derose Children's Dental Clinic in Pueblo.

Nationwide, the Deroses owned 22 clinics. Dr. Mueller is part-owner in 12 of them. All of the clinics cater to kids on Medicaid.

[All three sold their ownership in the company in 2007].

The Executive Director of Colorado's Medicaid office, the Colorado Deptartment of Health Care Policy and Financing, was astonished at the police photographs of the children that 9NEWS showed her.

"This is really extreme," said Karen Reinerston. "If these injuries were caused by the papoose board, it is not a nice little blanket that you wrap around them and make them feel like a papoose."

Drs. Michael, who had medicaid billing issues in North Carolina in 2005, and Ed Derose and Dr. William Mueller would not talk to 9NEWS on camera. But in an audio-taped interview, Mueller says they use papoose boards to protect children. "They're used so the children won't make a movement in an inopportune time and hurt themselves or cut themselves," said Mueller.

But at a clinic in Phoenix, Arizona, which is co-owned by Dr. Mueller and the Deroses, 4-year-old Jonathan Barrera died from an overdose of anesthetic while strapped to a papoose board.

The Arizona Dental Examiners Board investigated the dentist responsible, Dr. Matthew C. Nolen, saying the restraints "could have masked the signs of respiratory distress...or signs of the child going into convulsions."

Before he began working at the Arizona clinic, Nolen trained at the Medicaid Dental Clinic in Aurora, Colorado.

Nolen testified before the Arizona Dental Examiner's Board. He admitted that most parents did not know about an unwritten policy at the Arizona clinic to restrain every child under the age of 5.

A Board member asked Dr. Nolen "Is the papoose board common in your practice?" Dr. Nolen replied, "Very common."


(The report was clear that Dr. Matthew Nolen's treatment was below an acceptable standard of care.   They also found that Dr. Mathew Nolen was less than truthful with his informal testimony. (no surprise there) Paragraph 39 of the report issued by the AZ State Medical Board, states: "Dr. Nolen testified at an informal interview that it was routine clinic policy to place children under five years of age in a papoose board."  They also found "there was no credible evidence that Dr. Matthew C. Nolen and tried any other form of behavioral management techniques prior to restraining the child."(paragraph 51.  Dr. Nolen was hired and went to Colorado for training before he started treating patients at the Arizona Small Smiles clinics.)*
 
"Routine?" the Board member asked. "Pretty routine for children," said Dr. Nolen, "under the age of five."

Last April, the Arizona Dental Board revoked Nolen's license. One of its findings: that Nolen had used the papoose board on Jonathan because it was convenient; not because he had been misbehaving.

9NEWS has also learned Dr. Mueller was charged two months ago with gross malpractice at his clinic in Tennessee for "routinely and arbitrarily immobilizing kids up to 3-years-old on papoose boards, without justification, for longer than an hour for routine dental work".

Dr. Mueller denies his clinics have a blanket policy to use restraints.

Still, Colorado Dental Examiners Board is now investigating why they were used on these kids.

Jason Hopfer, of the Colorado Dept. of Regulatory agencies said, "If they're doing it simply because it's convenient, that is a concern."

9NEWS talked to an expert, Pediatric Dentist Dr. Bradley Smith, spokesman for the American Academy of Pediatric Dentistry in Colorado.

Smith says he rarely uses papoose boards in emergencies. "If a child comes in and they've fallen or broken their tooth or cut their lip or had some major oral trauma and we have to do treatment that day and we have no choice at all," said Smith.

Smith also prefers to have parents in the exam room with him while he works. "I want to be able to talk to the parent, I want them to see what I'm doing," said Smith.

The American Academy of Pediatric Dentistry and the Colorado Dental Examiners Board have policies that say restraints should be used only when absolutely necessary, for uncooperative kids, and should not injure them.

But 9NEWS learned that Medicaid in some states pays extra each time a dentist puts a child in a papoose board.

Drs. Ed and Michael Derose and William Mueller would not tell 9NEWS how often they use papoose boards in each of their respective clinics.

So 9NEWS used open records laws to obtain and analyze state Medicaid bills.

9NEWS learned in all other clinics across the state, dentists use papoose boards, on average, 4 percent of the time.

But at Mueller's 'Medicaid Dental Center' and the Deroses' 'Smile High Dentistry', their dentists put 21 percent of kids in restraints. In the year 2001-2002, those two clinics used papoose boards more than 2,500 times.

The cost to taxpayers for those papoose boards at four of their clinics; $106,473.

Karen Reinerston of the Colorado Department of Health Care Policy and Financing, thinks that is excessive.

"You shouldn't have to have a kid restrained all the time," she said. "I think it's very scary for the child."

Last year, Reinerston stopped Colorado dentists from charging Medicaid for restraints.

Dr. Mueller sent 9NEWS an e-mail saying he did not personally treat any of the children in the story.

Mueller also said he is not responsible for the care provided by other dentists in his clinics, because they work under contract and practice under their own licenses.


*
Matthew "Matt" Chemath Nolen

6400 E Thomas Rd., #3025
Scottsdale, AZ    85251 
AZ Dental Lic: D05399
Issued: 5-15-2001
Revoked: 6-30-2004

Something is just not right here. Kentucky suspends 180 dentists licenses for not paying their annual dues, and other states smack very few bad seeds on the wrists for strapping down children and insurance and Medicaid fraud. Don't we need a bit of consistency somewhere? No wonder dentists state hop when they get in deep doo doo in one state.

Wednesday, March 19, 2008

Kentucky suspends more than 180 dentists, angers health advocates

By ROGER ALFORD
Associated Press Writer

FRANKFORT, Ky. (AP) -- Oral health advocates in Kentucky are fuming over what they call "a bureaucratic nightmare" that led to the temporary suspensions of more than 180 dentists.

The suspensions are especially troublesome in a state that struggles with poor dental health, said Dea Riley, head of the Appalachian Roundtable, an advocacy group for residents of the state's impoverished mountain region.

"There seems to be very little logic in this maneuver," said Riley, who was angered that dentists in some rural coal towns had to close their offices until paperwork was processed to restore their licenses. "They need to be allowing these doctors to practice dentistry, not make it more difficult for them."

Riley said the move by the Kentucky Board of Dentistry wouldn't have been so irksome if Kentucky didn't already rank among the worst states in the nation in toothlessness. A study by the Kentucky Institute of Medicine last year found that 37 percent of Kentucky adults were missing at least six teeth.

Despite those dismal statistics, the dental board ordered the suspensions of dentists who missed a Dec. 31 deadline to submit paperwork and pay a $230 fee. Lisa Turner, the dental board's interim executive director, said 187 practicing dentists were affected. All have since returned to work.

Turner said the problem arose when the dental board changed the way it notified dentists about the need to renew their licenses.

In past years, letters of reminder were mailed to the state's more than 2,300 practicing dentists to remind them that their licenses were set to expire on Dec. 31. Last year, the dental board simply printed a notice in its fall newsletter.

"Apparently a large percentage failed to read the newsletter," Turner said.

Because so many dentists didn't renew their licenses, the dental board decided to send a postcard reminder in December. It, too, went unheeded, she said.

Turner said the problem coincided with a push by the dental board for all dentists to renew their licenses online.

Dr. Scott Browning, a dentist in Vicco in rural eastern Kentucky, said he was surprised to learn in January that his license had been suspended because of the communications breakdown. He said he initially learned about his suspension when he called an oxygen supplier to place an order. He then called the dental board to verify what the supplier had told him.

"They should have a way of contacting the dentists," Browning said. "All it would have taken was a phone call."

Browning had to close his office for a week, postponing all appointments that he could, while frantically trying to get patients suffering from tooth pain into nearby dental clinics.

"That is what was really making me angry," he said. "I couldn't help my people."

Riley said it's little wonder that Kentucky is the butt of jokes about its poor dental health when the state suspends the men and women responsible for caring for teeth.

"This affects our national reputation," she said

Never Leave Your Child With Dr. David Moore, DDS


Remember Dr. David Moore, DDS, the dentist in Charlotte, North Carolina who was suspended a mere 6 months in 2006 for physically abusing several children?
One mother, Lachandra Beasley had filed a police report as far back as 2002 when her son, Tyreese has seen Dr. Moore. Tyreese had reported:
“I was struggling because everybody was holding me down-my arms and my shoes- so I kept struggling. He put something inside my tooth and started smacking me with gloves on.”
Tyreese’s mother said police were supposed to follow through on the complaint but she never received a follow up report from police.
I guess the police didn’t take the report about a dentist physically abusing a child very seriously back in 2002 and things haven’t changed much. Same with Keily’s mother who found her child was abused by Dr. Mike Kort in Bull Head, Arizona a few months back as reported and updated on this blog. (link)
Then in January 2006 WCNC TV in Charlotte reported Dr. David Moore had been suspended for 6 measly months for slapping, kicking, shaking, and pinching children. He reportedly banged children’s heads against chairs, pulling kids down on the chair with their ponytails, hit them in the forehead with his fist and grabbed them out of the dental chair by their necks and their upper teeth.
Dr. Moore, signed a consent order with the North Carolina Dental Board agreeing there were factual basis to the claims against him even though his attorney said he denied all the charges.
Few employees testify against Dr. Moore. However, at least two former employees, Tina Cooper and Meta Parsons talked to WCNC TV saying it was like working for Dr. Jeckyl and Mr. Hyde.
Cooper worked in Moore’s office for 10 years and Parsons worked there for five. Parsons reported she has seen him clamp his hand over the mouths and tell the children to shut up. She also said she had seen him pound on the children’s chests!
Both women reported they stayed as long as they did to try and protect the children under their care. Keepers of the child so to speak. Parson’s said her breaking point was when she found Dr. Moore sedating children without her presence and leaving them alone, unmonitored. These children could have died! Never leave your child alone with Dr. Moore!
Cooper left after testifying to the dental board. Both said it was tough for them to leave what they witnessed this doctor do to children behind them after they left his employment.
What ever happened to Dr. Moore, well he’s still in business. Yep, that's right. This dentist can do this, the dental board does little and the police do nothing!
He’s the top dog at Charlotte Pediatric Dentistry and Orthodontics with 3 locations:
Billingsley Medical Dental Center
411 Billingsley Rd.
Suite 106

Charlotte, NC 28211

(704) 377-3687
Mallard Creek Medical Park
10320 Mallard Creek Rd.
Suite 150

Charlotte, NC 28262

(704) 547-8438
And
Morris Professional Center
7215 Lebanon Rd.
Suite G
Charlotte, NC 28227
(704) 545-0390
Dr. Moore has a daughter named Ryan, wonder how he would like to have his daughter treated like he treated other children?
The Dental Board is ready and waiting for more reports of abuse by Dr. David Moore that could lead to further disciplinary actions, so if your child has been abused my Dr. Moore, I urge you to contact the police and the dental board as soon as possible.
Dr. Moore's license status says he's still under probation.