Sunday, August 02, 2009

Kool Smiles Still Up To Their Old Tricks.

Dan Stockman of the Journal Gazette in Fort Wayne Indiana gives us another report:

http://www.journalgazette.net/article/20090802/LOCAL10/308029918


Published: August 2, 2009 3:00 a.m.

Not everyone’s smiling

Medicaid dental clinic defends itself against critics

Dan Stockman
The Journal Gazette
By the numbers
Kool Smiles has 84 dental clinics nationwide, including six in Indiana, and focuses on treating children on Medicaid. Here’s a look at its Medicaid work in Indiana in 2008:

Kool Smiles patients

Indianapolis 2…7,195

Indianapolis 1…6,949

Fort Wayne…6,013

Evansville…5,733

Highland…2,890

Terre Haute…2,055

Medicaid reimbursements

Indianapolis 2…$2.7 million

Indianapolis 1…$2.5 million

Fort Wayne…$2.4 million

Evansville…$1.7 million

Highland…$1.1 million

Terre Haute…$746,000

Indiana$11.1 million

Percentages

•Medicaid and CHIP patients treated by Kool Smiles: 7.8 percent

•Medicaid and CHIP claims filed by Kool Smiles: 6.6 percent

•Medicaid and CHIP reimbursements paid to Kool Smiles: 6.8 percent

Deanna Vasquez said she realized something was wrong when she found herself helping a dental assistant hold down her 4-year-old son’s arms and legs as he writhed and screamed.

“You’re basically brushing his teeth,” she said. “I thought, ‘I could do this at home without holding him down.’ ”

But it wasn’t just her son’s screams that left her queasy, she said. It was also the screams of other children – from behind the closed doors of other rooms at Kool Smiles dental clinic, 1852 Bluffton Road.

“Kids were screaming their heads off,” Vasquez said.

She saw one girl emerge. She was 8 or 9 years old, Vasquez said, and had obviously been sobbing. Her parent was in the lobby.

Five sets of parents told The Journal Gazette that Kool Smiles does not allow parents to be with their children during cleanings or procedures. Vasquez’s presence with her son was allowed, she said, only because she insisted she could help calm him down and that they would leave otherwise.

Kool Smiles denies barring parents from its procedure rooms and says its staff acted appropriately.

The national chain of 84 clinics has been accused of overtreating its patients, of prohibiting parents from procedure rooms and of being too quick to restrain the children it treats. Kool Smiles denies any wrongdoing.

Vasquez worries she did the wrong thing in helping Kool Smiles restrain her son – something she now regrets.

Crystal Allen understands.

She had taken her children to the dentist every six months, she said, until financial problems made it impossible. A year after their last appointment, her daughter had a toothache, and Kool Smiles in Fort Wayne was the only practice she could find to see her immediately.

“They made me feel about this tall when they told me how badly I had neglected their teeth,” Allen said. “I left there thinking I didn’t deserve to have kids if I couldn’t take care of them.”

Then came the hard sell, she said.

Kool Smiles said her daughter, 10, needed stainless-steel caps put on four of her baby teeth, and her son, 5, needed six stainless-steel caps. Immediately.

“They were like, ‘This is so important, you need to get it done now. We can make time today; you don’t know when these other teeth are going to go,’ ” Allen said. “I was like, ‘You’re kidding.’ And he was like, ‘No, she’s here, she needs to get it done.’ ”

Then Allen looked around the waiting room.

“There were two kids there, and every tooth in their mouth was stainless-steel caps, including their front teeth,” she said. “Top, bottom, front and back.”

Dropped in home state

Kool Smiles specializes in treating children on Medicaid, a federal health insurance program for the poor run by individual states.

That means taxpayers cover the cost of most of the care provided.

Kool Smiles, based in Atlanta, lost its authorization to do Medicaid work in its home state two years ago because of allegations it was overtreating its child patients and questions about its practice of strapping children down.

According to WellCare Health Plans, the company that handles Georgia’s Medicaid program, Kool Smiles dentists were performing 17 percent more procedures per patient than other dentists.

When compared with patients of other dentists, WellCare said, a child treated by Kool Smiles was:

•Five times more likely to receive crowns.

•Four times more likely to receive five or more crowns.

•Forty percent more likely to have their teeth pulled or extracted.

•Three times more likely to be physically restrained during dental procedures.

While Kool Smiles patients were about 5 percent of WellCare’s dental clients in Georgia, those patients accounted for about 20 percent of the Medicaid money spent on dental care in the state, WellCare claimed.

Dr. David Strange, chief dental officer for Kool Smiles and the company’s national spokesman, said the company has been cleared of all allegations. Doral Dental covers dental work for WellCare.

“We have letters from Doral, the third-party provider in Georgia, really, that we’re quite proud of, stating that they did not have any clinical issues with the charts that had been reviewed,” Strange said.

“We received numerous letters, numerous accounts from Doral stating that they don’t have issues and don’t have concerns with the care provided by Kool Smiles associate dentists.”

But the letters Kool Smiles provided as proof it had been cleared do not refer to the allegations made by WellCare. The letters, written in January, refer only to specific Kool Smiles locations and say they are in response to audits requested by WellCare in September and October 2008.

The allegations that led to Kool Smiles’ contract with WellCare being dropped were made more than a year before, and the audit was being conducted by the Georgia Department of Community Health’s Inspector General.

That audit, according to Georgia Department of Community Health officials, found Kool Smiles had performed a “large number” of tooth restorations on children without anesthesia; excessive treatments during the same visit without some type of sedation; large amounts of local anesthesia given to patients below the proper weight; and one treatment in a Kool Smiles clinic that should have been performed in a hospital. Kool Smiles settled the charges with the state in January 2008 for $193,508.

A follow-up statement from Kool Smiles says its contracts were dropped “without cause” and that the allegations made by WellCare were unfounded. Georgia officials said Kool Smiles as a group is still a Medicaid provider, but the 18 locations involved in the investigation are not.

Investment-firm owned

Kool Smiles was started in 2002 by Dr. Tu Tran and Dr. Thien Pham. Today, the chain of clinics is run by NCDR, a limited-liability corporation formed in Delaware, headquartered in Atlanta and owned by the San Francisco investment firm Friedman Fleischer & Lowe, state records show.

Most states require dental offices to be owned by dentists. Tran and Pham own Kool Smiles – and incorporate a new Kool Smiles company in each state where clinics are located. The clinics are then run by NCDR or DPMS Inc., also owned by Friedman Fleischer & Lowe.

According to Indiana Secretary of State records, NCDR should not be operating in the Hoosier State: It has not paid its annual business license fee in two years, and in February, the secretary of state revoked the company’s authorization to do business here. State law provides for a $10,000 fine for operating without authorization.

Strange said he was unaware NCDR cannot legally do business in the state and would look into the situation. The company later said it appeared to be a paperwork problem that would be resolved.

The corporate structure means Tran is listed as the lead dentist on each of the dozens of Kool Smiles clinics across the country, though he does not practice at any location. Pham is in the process of retiring from the corporation, Strange said.

Kool Smiles’ 84 clinics span the nation, and so do the allegations against the company, especially from parents who say their children were given – at taxpayer expense – dental work they didn’t need (See related story).

Crowns are ‘routine’

Strange said allegations of over-treatment by Kool Smiles are unwarranted, and he says its patients are often children who are not receiving regular dental care and have severe tooth decay.

“I get asked all the time, does my child really need a crown? And the answer to that is very, very often a resounding yes,” Strange said.

“A stainless-steel crown that’s placed on a tooth that’s severely decayed, that has inter-proximal caries (cavities between teeth), on a child that’s at high risk for additional dental (cavities), a stainless-steel crown is oftentimes the most effective, most reliable and most well-suited dental treatment that can be provided.”

Dr. Bradley R. Smith, a Colorado dentist and a spokesman for the American Academy of Pediatric Dentistry, said it is difficult if not impossible to make blanket statements about placing crowns as opposed to fillings on teeth, even on baby teeth that will fall out within a few years.

“If the patient has never been to a dentist and I have very little confidence I’m ever going to see that patient again, I’m much more likely to do a crown because I know it’s more resistant to decay in the future,” Smith said. “That’s a reasonable decision the doctor has to make for each individual patient.”

Smith said it comes down to informed consent: Do the parents understand all the options and the implications of each one?

If not, “then that’s not a good thing,” Smith said.

Strange said the patients Kool Smiles sees might never have been to a dentist and might never return, so it makes sense they would do more crowns.

“We’re seeing children for the first time at age 4, 5 and 6. They have extensive needs without a dental home. … We’re seeing children where the effects are really quite devastating throughout the entire oral cavity,” Strange said. “Crowns are very much a part of routine children’s pediatric dental care.”

‘He passed out’

Noah Fedele-Woodley, 4, went to the procedure room alone at Kool Smiles’ location in Newport News, Va., because his mother and grandmother were not allowed to accompany him, said his grandmother, Carol Fedele.

“They brought him out screaming. He was soaking wet,” Fedele said. “He was literally saturated from head to toe from crying and sweating. … Once his mother was holding him, he collapsed. He passed out in her arms.”

Burst blood vessels were found on Noah’s face and neck, known as petechial hemorrhaging clusters, which can be caused by trauma to the skin or stresses such as intense vomiting.

“(The dentist) said it happens all the time; they get it from crying,” Fedele said. “He said, ‘They all do that; they just showed up on him because he’s light-skinned.’ ”

Noah’s Kool Smiles records from that visit show the boy was restrained for 25 minutes. Noah’s mother had signed a consent form six months before, in July 2008, but had no idea she was giving permission for Noah to be strapped down, she said. The form is labeled “Pediatric Dental Patient Guidance Techniques.”

Noah also had bruises on his cheeks, Carol Fedele said, as if his mouth had been squeezed open.

Kool Smiles employees reviewed Noah’s records “and continue to believe we provided medically necessary dental treatment,” the organization said in a written response. “Kool Smiles adheres to the treatment policies and guidelines of the American Academy of Pediatric Dentistry and the American Dental Association.”

The American Academy of Pediatric Dentists’ guidelines say restraints should be used only as a last resort and are meant only for medically necessary treatment.

“The use of protective stabilization has the potential to produce serious consequences, such as physical or psychological harm, loss of dignity, and violation of a patient’s rights,” the guidelines warn.

Strange did not deny that Kool Smiles patients are three times more likely to be restrained but said it was “an apples-to-oranges comparison” because Kool Smiles sees only children.

“We see a patient population that is, generally speaking, younger than the other dentists’ in the community,” Strange said. “It’s kind of like saying a preschool compared to grade school uses more crayons and that using more crayons is somehow inappropriate.”

So younger patients are going to require more restraints?

“Younger patients require different types of treatment. Protective stabilization happens to be that type of treatment,” Strange said.

Strange said that with parental consent, it can be appropriate to restrain a child for any treatment, even an exam.

“This needs to get back to the focus, and the focus is really on the children, and if you can’t do an exam, then you’re not focusing on the child,” Strange said. “From my perspective, from a clinician’s perspective, that’s key.”

An assembly line?

For years, advocates for the poor have complained it is difficult to get dental care because so few dentists are willing to accept Medicaid patients, at least in part because of low reimbursement rates.

But Kool Smiles has found a business model specializing in Medicaid patients. The corporate information Web site Hoovers.com estimates NCDR has 500 employees at its Atlanta headquarters and did $20.1 million in sales nationally in 2008.

In 2008, the Indiana Family & Social Services Administration, which administers Medicaid, reimbursed $2.4 million to Kool Smiles in Fort Wayne. Statewide, the six Kool Smiles locations were paid $11.1 million in Medicaid reimbursement last year.

Unlike the statistics in Georgia, Indiana FSSA figures show reimbursements to Kool Smiles in line with their number of patients.

Still, the Kool Smiles business model thrives on volume. FSSA said the Fort Wayne clinic had more than 6,000 separate patients in 2008.

Dr. Todd Parco, a dentist in New Mexico, even placed a help-wanted ad for dentists tired of the fast pace at Kool Smiles.

“If you are wanting to get out of the dental mill scene like Kool Smiles … and want to find something infinitely better, give us a call,” the ad said.

The Fort Wayne Kool Smiles hygiene bay contains six dental chairs, so six cleanings can be performed at a time.

Kool Smiles rewards its dentists for working fast – they can earn bonuses of more than $10 an hour for production, according to a help-wanted ad the company placed in a trade publication.

“In any profession, the more productive you are, the higher your compensation,” Strange said. “The point that really needs to be made is at Kool Smiles, we are very, very particular and very committed to ensuring that all of the dentistry that’s provided is quality dentistry.”

Strange also disputes claims the company keeps parents out of Kool Smiles treatment rooms.

“The company doesn’t have a policy where parents are excluded from participating in treatment with their children,” Strange told The Journal Gazette. “The company does have a philosophy that most children do well without the presence of the parent. However, we do have an open door when it comes to treating children, and our parents are actively encouraged to participate in the Kool Smiles dental experience.”

But parents from five different families contacted by The Journal Gazette said they were told it was company policy they could not accompany their children and that children whose parents insisted on staying with them would not be treated.

A sign in the waiting room of the Fort Wayne Kool Smiles on July 21 stated: “Parents MUST remain in the waiting room while your child is being treated or they will NOT receive treatment.”

Strange said the sign meant only that if parents choose not to accompany their child during treatment, they cannot leave the premises. That sign has since been removed.

“I was not allowed to go back” to the treatment room, Crystal Allen said of her children’s visits to Fort Wayne Kool Smiles. “I was unable to see anything.”

Christina Bergbower took her children to the Terre Haute Kool Smiles and was told it was company policy that she could not accompany her children.

“I said, they’re a minor, and by law I can be there with them, and they told me it was their policy – it was on the wall that it was their policy,” Bergbower said. “They make it very clear to you that parents are not allowed in the back.”

Strange said that is not true at any Kool Smiles location.

“The short answer is absolutely no, we do not have a policy that precludes parents from being in the back or in the operating treatment facilities with their children,” he said.

BBB grade changed

A dentist at the Terre Haute Kool Smiles told Bergbower that her 6-year-old son Cody’s tooth was so decayed he had to have a stainless-steel cap put on it. When she took him to another dentist, however, the cavity was found to be so small they were able to fill it without using Novocaine.

Bergbower’s 16-year-old daughter, Shauna, was told by Kool Smiles she needed fillings for four cavities. Another dentist could not find any.

“I showed them the paper from Kool Smiles,” Bergbower said. “She said if she would have had those teeth filled, it would have caused pain and discomfort and set her bite off.”

Strange said Kool Smiles has a vigorous internal-review process that investigates any complaints made, but it gets few – just one-half of 1 percent of their patients complain, he said.

The Better Business Bureau in Fort Wayne gave the Fort Wayne Kool Smiles a grade of F because a customer had filed a complaint and the BBB never got a response from the company.

“An unanswered complaint is a big deal in the BBB system,” said Michael Coil, president of the BBB of Northern Indiana. “All you have to do is respond. We’re not saying they’re wrong or right. All we’re trying to do is get their side of the story.”

Kool Smiles says it did respond, but the BBB somehow never received it. It refiled its response after being asked about it by The Journal Gazette, and the grade was changed to a B-. It was later changed to a B+ when the company responded to a BBB survey asking for basic company information.

Strange said the situation appeared to be an oversight.

“That’s certainly uncharacteristic that we wouldn’t have responded,” Strange said. “We really, truly are people interested in doing the right thing.”


Kool Smiles has dozens of children’s dental clinics across the nation, but the company has also been the subject of complaints across the nation.

The dental licenses of Kool Smiles founders Dr. Tu Tran and Dr. Thien Pham, and Kool Smiles’ regional director of dental operations, Dr. David Vieth, were put on one-year probation in Massachusetts. The probations ended in June.

All three were disciplined for violations including that three clinics failed to perform required weekly biological testing, failed to maintain sterile instruments and didn’t maintain hepatitis vaccination records for employees, and that one clinic allowed an unqualified dental assistant to place dental sealants on a patient.

In addition, Pham was disciplined for anesthesia violations.

“That was an opportunity for us to learn and improve, and we’ve done so,” said Dr. David Strange, Kool Smiles’ chief dental officer and national spokesman.

Allegations also have been made by parents and news organizations.

In Hampton Roads, Va., WAVY-TV reported in November that one parent was told by Kool Smiles that her daughter needed eight stainless-steel crowns on her teeth. After four were put on, she got a second opinion from a dentist who said she didn’t need any.

Another parent was told by Kool Smiles his son had seven cavities that needed to be filled; a second opinion found none.

In Atlanta, WAGA-TV interviewed a former Kool Smiles employee in November who used her cell phone to film the office manager cleaning children’s teeth, though the manager was not a licensed dental hygienist. Strange told the TV station the employee had been dealt with internally.

dstockman@jg.net

Wednesday, July 29, 2009

Clearly They Know of the Fraud and Abuse

After the President's remarks last week about pediatricians doing unnecessary tonsillectomies on children (which by the way, it would take a surgeon) you would think his administration would shut these dental mills down, but so far nothing. In fact there was more movement toward this in the prior administration than there seems to be now. However, I guess there could be things going on behind the scenes than I'm aware.

At least he admitted he knows stuff like this is happening, but I wish he had used the example of these dental mills than the pediatricians.

Tuesday, July 21, 2009

CBS Channel 6 Reporter, Steve Flemisch Updates Us On Small Smiles

7-20-2009

CBS Channel 6 reporter, Steve Flemisch, in Albany NY says Small Smiles owners and staff probe continues and may face serious consequences. Small Smiles now goes under the name Albany Access Dentistry.

Wednesday, July 15, 2009

Kool Smiles Still Crappy

http://www.mypennypile.com/2009/07/kool-smiles-not-cool.html

Tuesday, July 14, 2009

Ameriplan Insurance Accepted at Small Smiles Montgomery

I don't know anything about "Ameriplan" insurance and don't pretend to. What I do know is that Small Smiles Of Montgomery (Alabama) is now accepting their "insurance"?


Click here.

So what does this mean? I dunno but will be looking into it. Of course birds of a feather, flock together, right?

From what I've read, Ameriplan is not exactly insurance, but you get a list of providers that may give you a discount on treatments, I'm not sure.

So is FORBA Small Smiles looking into other avenues of revenues? It's looking like it.

Anyway Ameriplan sounds a bit like Amway.


Ameriplan Work At Home Scam?

Ameriplan at Rip Off Report

Ameriplan on Yahoo Answers

Monday, June 22, 2009

Smile Starter and the EEOC

I've not been able to confirm this but I did receive an email reporting that Smile Starters in North Carolina, the same company fined $10 million dollars for medicaid fraud in 2008 are back under federal investigation once again. Only this time it's for discrimination.

Smiles Starters was originally owned and operated by Michael A. DeRose and Letitia Ballance, but soon after investigation for fraud, over treatment of children (doing root canals and crowns on perfectly good teeth, sometime up to 16 at one visit) they supposedly sold the clinics to Dr. Raf Rivera, but that sale remains in question since Dr. Raf was an employee of DeRose and Ballance. Many think DeRose still has his hands in that business.

Both Dr. DeRose and Dr. Ballance were sanctioned by the North Carolina dental board. Dr. Ballance went on to open more medicaid dental clinics, one in Waynesville, NC going under the name of Carolina West Dental.

Why she (Dr. Ballance)is still allowed to bilk medicaid and earn a living using the medicaid system in North Carolina is a question the baffles those who know about it. In fact it is baffling why either of these dentist still have a licenses to practice dentistry in ANY state, and certainly baffling as to why they are not in jail.

Wheather FORBA (of Small Smiles) fame is still associated with these clinics is also in question. At times over the past couple of years, Dr. DeRose has made mention he still owned them, and other times he's stated he sold them with Small Smiles to FORBA. But if asked FORBA will tell you they don't 'own' any dental clinics, they only manage them.

Here is the email I received"

Yes, Smile Starters is back under the eye of the Federal Government. Now they are under investigation for employee discrimination. Look into the EEOC, there are three counts of discrimination against them. They are now firing their most experienced staff and replacing them with unexperienced staff for half the salary. I assume they are trying to make up for the $10 million they had to dish out for Medicaid fraud.

Friday, June 19, 2009

Dr. Steven Adair Talk Tooth Decay to USA Today

This one just cracks me up. Seems Dr. Adair talks to USA today about tooth decay and children drinking so much soda.

That would be all fine and good except he should tell that to the co-owners of FORBA: Dr. Michael DeRose, Ed DeRose and mostly Dan DeRose. Dan because he's the guy who marries school systems with cola and junk food companies to put those drink machines in the schools.

Hypocrites!

Atlanta's Fox 5 I-Team's Randy Travis' Report On Kool Smiles



ATLANTA (MyFOX ATLANTA) – Kool Smiles was once the leading provider of dental care for Georgia's poor. Last year the company lost two major contracts the dental chain is still answering questions about how it treats its young patients. FOX 5's Randy Travis reports.

Link To Report

You gotta just love this Dr. Strange dude. They always have the right answer don't they. Sounds like a script doesn't it?

Same ole story from the corporations isn't it; underserved, not fair to compare our stats to other dental service providers, and people with children on medicaid don't brush their teeth.

WAVY TV Report Video

WAVY TV Kool Smiles Report, by Derrick Rose




Small Smiles Receives 4 Million in Reimbursement in Wichita


(note that once again, the powers that be at FORBA, Al Green, Michael Lindley, Todd Cruse or any of the DeRose's are no where to be seen)


March 25, 2009
by Michael Schwanke (WICHITA, Kan)
Contact FactFinder 12 at investigators@kwch.com or 316-831-6166

Small Smiles Dental Clinic is among the top three providers of Medicaid dental services in the state.

It received more than $4 million in the last two years. That's about six percent of all Medicaid reimbursements for dental services.

"It was money, money, money. It was not about the health or the welfare of the children, it was get as much money as you can," says a former Small Smiles employee who wanted to remain anonymous.

She worked for the clinic in 2005 and was fired after about year.

She called us after seeing our initial story.
We talked to three Wichita families told us about their experiences with Small Smiles. They accused the clinic of performing unnecessary dental work, not explaining procedures, and traumatizing their little girls.

The former employee says what the parents told us happened all the time. She also says the clinic had to meet quotas.

"Every single morning that's what our meeting was about...money and how much we needed to produce that day."

But since 2005 Small Smiles says changes have been made. There are no longer quotas, and patient care has improved.

"As I did mention before we have changed policies. We're doing everything possible to make sure parents are involved in the care of their children allowing them to be in back with their children, creating an 800 number to get in touch with us and making sure dentists take the time to talk to parents about the treatment their children are going to receive at Small Smiles," says Small Smiles spokesperson Don Meyer.

Despite those changes, the story has caught the attention of the Kansas Health Policy Authority. That's the agency that oversees Medicaid.

It tells us it is aware of the concerns voiced by parents, and that every grievance reported to them is investigated.


_______________________________________


Comments:


Nikki:

The have not changed since 2005. In 2006 my daughter was there to get some cavities filled. She was 4 yrs old at the time. All they did is cap over the cavities without taking them out. 6-7 months later my 4 yr old had to have 12 teeth pulled out.... 1 every few weeks because her teeth that she got filled were absessing one by one. And they also never let me go back with her. I think it is horrible that just because i get healthcare from the state my daughter doesnt matter. Everyone says there is nothing I can do. My little girl had to suffer for almost a year. And there is no way for any lawyer or even small smiles themselves to make this right? She still has 2 spacers in her mouth from it. Small smiles needs to be closed down before they have a chance to hurt anymore children. Just because im not rich doesnt mean my child doesn't deserve better.


Jennifer:

I have three young daughter, whom two have been attending small smiles dental clinic for the past 3 years. Both of my daughters have had several things done (7 yrs old and 5 yrs old). I have had my doubts for the past two years, but since I have medicaid for them i had no where else to turn to. I called a place here is town a pediatric dentist about a year ago and they did not take medicaid. I just happen to make that call again about a month ago and found out that they now take medicaid. I took in my daughter for a regular check up and I am very sad to say they have to REDO and put my child to sleep to fix the work small smiles has done to my daughter....this is not just one small thing she is going to get several things done....I am so MADDDDDDDDD. How could I let this happen to my child. I trusted them. One thing I can not understand is how could they bill for things they never did or have done things they should not have done??? where do you turn to? Who is going to listen? At this point I just want my child to get the care she needs. I think Medicaid people just get swept under the rug...because never the less we are getting Meidcal help with little or no cost...so we should just be thankful...that should not be the case. I think this place preyed on the Medicaid patients and it needs to stop.


Edie:

hello i just saw your story on small smiles dental clinic and i have to tell you i have been takin my girls there since @ 2005.....and i have never had any trouble with them.my girls have never been scared to go there and the staff has always been courteous and helpful..answering any questions i have had regarding the treatments and procedures on my children.they have also always welcomed me to come in the back and watch if i so desired....i live over 100 miles away and have no problem driving that far for the care my children receive....they are usually pretty accommodating if my children need additional services other than cleanings to get it done that day so i do not need to make additional trips....i believe as with any dentist there are going to be some patients who just do not care for the service they receive...children and adults are usually apprehensive about dentists i know i am....but i believe there as been no wrong treatment in the care of my children's dental needs...thank you...edie haskell





Wednesday, June 17, 2009

Yes, Small Smiles is Now Hiring in Phoenix

Looks like I was correct about the job openings in Phoenix...LOL. This was posted today, just one day after the release of the videos in the prior post.

Small Smiles in Phoenix

Tuesday, June 16, 2009

Appears To Be Small Smiles Employees In Phoenix Having a Bit of Fun

Here are the videos that were sent to me.

After posting the links to these videos from youtube user je3579 in a previous post I sent them on to Mr. Todd Cruse, of FORBA (Nashville, TN and Pueblo, CO) who operates the Small Smiles clinics, for review. I guess they were from the Small Smiles clinic in Phoenix since they disappeared almost immediately, I wasn't sure at first but since they were removed from the user account within an hour of passing them along my guess is they were in fact Small Smiles employees have a bit of fun. Until Mr. Cruse had them removed, there were several more videos, some with a dancing Santa and more.

I'm just guessing but I bet there are some job openings this afternoon in case anyone is interested in joining such a fine organization.

I sure wish I had the video of Jamie eating the banana from between the legs of the guy. The stars of the show were said to be Jamie-the dental hygienist Alex-the dental assistant and Dr. Karen Chu the lead dentist of Phoenix, AZ Small Smiles.

Don't you just love stupid people who would do this at work and post it on the Internet. Makes you wonder if FORBA checks to see if people have brains before they are hired. Anyway, as you could clearly see the dentist that briefly appears in one of the films could care less about what his employees are doing. I wonder who is behind the camera.

Way to go Jamie!

Your tax dollars at work, folks. Yep, these clinics are a glimpse into socialized medicine. See, these clinics operate solely on your tax dollars through SCHIP programs in various states. They treat low income (or as FORBA calls them, "underserved") children and receive medicaid dollars from your state.









Here is one of the comments that was posted anonymously:

I know of all these employees personally and I can tell you that Dr. Karen Chu the owner and Lead Dentist of the Phoenix Small Smiles had dared the dental hygienist Jaime Evans and the dental assistant Alex Corral to post this video on You Tube. The Pediatric dentist Dr. Quentin Shaw also thought these videos were funny and is in the Chicken fight video. This all happened when patients were in the office being treated.
As was said to me and I shall repeat it: "People really need to be tested before they are hired by FORBA Small Smiles"!!



6/14

DENTISTS
DENTISTS, HIRING now in SC. Paying a SIGNING BONUS in FLORENCE! Offering excellent guaranteed salary & benefits, including 100% paid health, 401K, Paid Vacation & more. New Grads & General & Pediatric Dentists are encouraged to apply. Fax or email resume to Jenna at 719-584-7696 or Questions? Call 719-562-4462.

Anyone At FORBA Small Smiles Willing To Comment On These?

I'm told these are the people who are treating the children in Phoenix, AZ. I sure hope this is not the case.

If you click on these videos now, they are gone! I sent them to Todd Cruse this morning and asked about them. I guess that proves they were from the Small Smiles clinic doesn't it, cause within an hour every one of them were gone.

All were sent to me but I don't have a copy of the worst one where the dental assistant is eating a banana from between the male's legs. It was titled Jaime really likes Bananas (They made me do it Dr. Karen).

Stars are Jamie-the dental hygienist Alex-the dental assistant and Dr. Karen Chu the lead dentist of Phoenix, AZ Small Smiles.






Monday, June 01, 2009

Things Too Quiet On FORBA Small Smiles Investigation

Just returned from a trip to New York City, I'm not going to say weather it was totally business or not but I can say Small Smiles and FORBA's name came up at a few gatherings.

Most of us who have known that medicaid Inspector Generals in several states have been investigating the fraud and child abuse at FORBA's Small Smiles Clinics are starting to wonder if they are just going to let this pass by without prosecution. It's sure starting to look like it. We are hoping that our government protects us better than that, but one just never knows.

To any of the local Investigative reporters out there, maybe it's time for a follow up story. We have to stay on this or we all know what will happen, NOTHING!

I'm not exactly sure but I think there is an attorney out there who would love to take this on. See the term 'qui tam'.

Saturday, May 16, 2009

May 2009 Update

Sorry I've not posted in a while. I'm sure some have missed me while others, well, not so much. I've just been busy with life and awaiting on some news out of New York on FORBA.

For anyone wondering about the lawsuit FORBA filed, well they ended up dropping it all! They asked the judge to dismiss all their complaints and the judge signed the order.

Basically, I didn't cave, I stared them in the face without fear until they backed off. I believe you can find all the legal stuff online if you want to see for yourself. Heck there might be a blog about it one day.

I guess they racked up a $60, 000 dollar legal bill with their attorney's since that was the last figure I heard and laughed hysterically at. I suggested to their attorney to get that in cash from their client ASAP.

These people are kind of like the school yard bully. Don't cower down to them.

Don't think I'm not still on the case, because I still am. You know, the quiet before the storm as they say.

Monday, April 13, 2009

Todd Cruse Involved In Shady Business While In Sundquist Administration

Todd Cruse is married to Lesa Hensley.  Lesa is daughter of lobbyist Tom Hensley "The Golden Goose" in Tennessee politics.  

NewsChannel 5 Investigates: Friends in High Places
E-Mail May Provide Valuable Clues in Contracts Investigation
(Story created: 10/31/03)

First, there were raids. More recently, there's been a parade of witnesses before a federal grand jury investigating state contracts. Now, thousands of e-mails could provide important clues about how the Sundquist administration handled those contracts.

Millions of people communicate every day by e-mail.

So when investigators began investigating contracts handed out by the administration of former Gov. Don Sundquist, they quickly issued a federal grand jury subpoena for thousands of e-mail messages. Included was a demand for messages to and from Sundquist and other top officials.

The probe was prompted by our Friends in High Places investigation

"People put things in e-mails never expecting that they are going to have to explain them," says retired FBI agent Ben Purser.

A sampling of the e-mails provided to the grand jury -- and obtained by NewsChannel 5 -- deal with a request for proposals for computer services. RFPs, as they are called, are supposed to be judged by an impartial selection panel.

"What you are holding in your hands could very well be evidence," Purser tells NewsChannel 5's chief investigative reporter Phil Williams.

For example, there's an August 2002 e-mail from Sundquist's chief administrative officer Todd Cruse.

"When do you anticipate putting together the selection panel," Cruse asks the state's head of information resources. "I have an interest in who we choose."

Cruse would later become a lobbyist for SCB Computer Technology, one of the state's big computer contractors and a bidder for the job.

"Perhaps, and I emphasize perhaps, there could be some influence there," Purser observes.

Cruse, however, tells NewsChannel 5 he was just expressing a naive curiosity about how the process worked.

But that's not how it was taken at the time.

"Honoring his request is simply out of the question," wrote Richard Rognehaugh, then the state's new head of information resources, to Finance Commissioner Warren Neel.

Neel responded, "My guide is and remains.. keep the process clean and above reproach.

That same process was used to hand out hundreds of millions of dollars in contracts. Investigators will want to know if there were efforts to stack other selection panels -- and if there were other department heads who were more willing to go along with those efforts.

Cruse's e-mails also hint at pressure from powerful Senate chairman Jerry Cooper relating to a homeland security project.

"I would like to be able to tell Senator Cooper when he calls, again, that I am getting a response out to her by the end of the day," the Sundquist administration official wrote.

The "her" was Cooper's wife, who was lobbyist for a company that wanted in on talks about the contract.

Purser says, "The e-mails that you've shown me would demonstrate the amount of political influence that is being used in a process that is supposed to be void of political influence."

Those e-mails are just a tiny fraction of what the state's computer experts are recovering from computer backups. The grand jury subpoena demands messages from the highest levels of the Sundquist administration.

The subpoena for e-mail records was issued last December. But the state's computer experts say restoring backups has been such a massive chore that they still aren't finished with the job.

"Some of the folks did not appear to be habitual e-mail senders or receivers," Rognehaugh tells Phil Williams.

He says how much evidence that's available for the federal grand jury will depend upon the e-mail habits of the Sundquist administration officials now under scrutiny.

"The federal grand jury in any public corruption investigation is following a paper trail," Purser adds.

In this case, it's not paper -- but a trail of bits and bytes that some probably never realized they were leaving.

Thursday, April 09, 2009

Smile Starters Complaint #101

I have read the article on the Smile Starters investigation. I wanted to share a story about my visit with the Winston-Salem, NC Smile Starters in 2001. I went in to have my teeth cleaned and see about having my wisdom teeth cut out. When I went in the I never had a problem with my teeth, not a spot on them. They took an x-ray and told me I had 8 cavities in all my mollars. When I asked about why my teeth didn't hurt or have any spots on them, they told my I had a rare tooth decay disorder that caused my teeth to rotten from the inside out. I was 17 so my mom didn't go with me and I didn't know I could tell them no they can't prefrom the fillings. So i let them start drilling my teeth, they gave my 10 shots in my mouth and I felt EVERYTHING!!! When I told the dentist this she told me well we have already given you too much medicine you are just gonna have to be a big girl. Then I was flinching and moving while she was drilling and her exact words to me were : "You better sit still or I'm going to cut your mouth all up. I can't stop drilling fast enough to keep from cutting you." They couldn't cut my wisdom teeth out that day so hey scheduled me for 2 days later. I went in that day and they broke my jaw removing my teeth! They claim that I had roots that are 1.5 cm longer than normal and they curved backwards and attached themselve to my jaw bone. On top of that they give my 800mg IBuprofen to manage my pain.This was the worst experience of my life. Since then I have had nothing but problems out of my back teeth. I was someone that use to pride myself on my teeth. Now I have these large black fillings in my mouth that I hate. I hope these so called dentist are not allowed to put their hands on anymore children.!!!
Thanks
Heather K

Tuesday, April 07, 2009

Who Owns Pueblo, Colorado

Emails question who owns Pueblo, Colorado.

________________________________________________

I had emailed you a few weeks back about the DeRoses and life here in Pueblo, Colorado. When driving to work each day I can't help but notice a very large and fancy building being constructed in a new business park in Pueblo. I was wondering what type of business it might be. Yesterday I received a flier in the mail for "Park West Dental". Owners: Dr. John Millea and Dr. Juliann Padula Millea. "General Dentistry for Youth". "Most insurances accepted including MEDICAID...." This new office is about a quarter mile away from the new YMCA in Pueblo which is being heavily funded by donations from the DeRoses.
A few observations...
1. Again, I guess I'm surprised how much money there is to be made practicing pediatric dentistry.. Am also amazed that with such an expensive and elaborate building that one would be purposely trying to attract Medicaid patients. Most physicians in town cringe at the thought of a Medicaid based practice as you would go broke in a short amount of time.
2. Is reimbursement for Medicaid dental services still too high? I don't think the original intent of the program was for dentists to get rich off it.
3. How much do you want to bet the financing for this pair of young dentists (each looks to be in their early thirties) came from the DeRoses?.. I have a hard time believing that they are financing the building themselves. There are too many coincidences.
Of course, none of this is illegal. It just raises a question in my mind about the potential for ongoing fraud given the associations noted---i.e. Padula-DeRose-child's dentistry-close proximity to the "DeRose" YMCA building, etc...


_____________________________________________

So I sent out an email asking about this and here is what I was told:

Yes the dental clinic is owned by Dr. padula which is Dr. Eddie DeRose's brother in law so I am guessing it is Dr. Padula daughter and son in law. Dr. John Millea use to work at....guess what....DeRose Dentistry or now known as Small Smiles of Pueblo on Liberty lane. The YMCA is being funded and built by Dr. Eddie DeRose. The clan down there involves Dr. Eddie DeRose, Dr. Adolph Padula(bro-inlaw), Dr. John Parrish(bro-inlaw). Both Padula and Parrish were part owners of Small Smiles before FORBA bought them out and I am pretty sure the non compete clause included them so hence....they use their kids names. Probably gonna start up new clinics under their names to run FORBA out of town.


____________________________________________

Saturday, April 04, 2009

DeRose Involved In Health Club?

I found this post the other day on a website and was wondering if anyone has anymore information on this?




Dan DeRose is Mike DeRose's brother, and he was the subject of Medicare fraud charge in the mid-90s when he owned a local health club. The results of the lawsuit against him were never made public.

Thursday, April 02, 2009

Pay for Preformance

As ridiculous as this concept is, I hope FORBA execs are first inline.

Tuesday, March 17, 2009

A Look Into Kool Smiles In Kentucky

Each week I'm going to be taking a look into state filings of Kool Smiles, I'm starting with Kentucky.

Organization Number- 0669850

Name- Kool Smiles, PSC

Type-Kentucky Corporation

Status-Active

Standing-Good

File Date- 7/30/2007

Last Annual Report- 5/14/2008

Principal Office- 400 Galleria Parkway, Suite 800, Atlanta, GA, 30339

Registered Agent-CT Corporation System, 4169 Westport Road, Louisville, Kentucky, 40207

 

Corporate Officers:

President: Tu Tran

Director: Tu Tran

Incorporator: Tu Tran

Kentucky- Small Smiles and FORBA Holding

Kentucky

FORBA Holding, LLC
Small Smiles of Lexington, PSC
Small Smiles of Louisville, PSC

3-17-09 report

FORBA Holding, LLC

Organization Number-0674614
Organization Name- FORBA Holding, LLC
Type-Foreign Limited Liability Company
State Originated-Deleware
Origination Date-4-17-2006
Status-Active
Standing-Good
File Date-9-28-2007
Principal Office-618 Church Street, Suite 520 Nashville, TN
Signed by Manager-Rodney Cawood, Manager, EVP, CFO

KY 2008 Annual Report
KY 2009 Annual Report




Small Smiles Dental Center of Lexington, PSC
Organization Number-0673476
Name- Small Smiles Dental Center of Lexington, PSC

Type-Kentucky Professional Corporation
Status- Good
Standing- Active
File Date - 9/12/2007
Last Annual Report- 7/29/2008
Principal Office - 618 Church Street, Suite 520, Nashville, TN 37219

Registered Agent- National Registered Agent, 400 West Market Street, Suite 1800, Louisville, Kentucky.
Authorized Shares- 1000
Current Officers:
President- Kenneth E. Knott
Secretary-William Nash
Director-Robert F. Andrus
Director-Robert F. Andrus
Shareholder-Robert F. Andrus
Shareholder-Robert F. Andrus
Incorporator- Kenneth E. Knott
Assumed Names:
Small Smiles Dental Center
Small Smiles Dental Centers of Lexington
________________________________________


Small Smiles Of Louisville, PSC
Organization Number- 0662918
Name- Small Smiles of Louisville, PSC
Type-Kentucky Professional Corporation
Status-Active
Standing-Good
File Date-4/24/2007
Last Annual Report-7/29/2008
Principal Office: - 415 N. Grand Ave, Pueblo, Colorado 81003 (isn't that FORBA's address in Colorado...hmmm)
Registered Agent- CT Corporation System, 4169 Westport Road, Louisville, Kentucky 40207
Shares-1000
Corporate Officers:
President- Jodi Kuhn
Secretary-William Nash
Director-Jodi Kuhn
Shareholder- Kenneth E. Knott
Shareholder- Robert Andrus

Shareholder-Jodi Kuhn
Incorporator-Jodi Kuhn
Assumed Names: Small Smiles Dental Centers of Louisville, Small Smiles Dental Clinic, Small Smiles Dental Clinic of Louisville.
____________________________________________
Now it's my understanding that Kenneth Knott and Robert Andrus were fired by FORBA over some 'credentialing fraud', but I don't know that as fact.
They used to be listed as the following until FORBA updated their Corporate Contact sheet in August or September last year.
Ken Knott- SVP Central Region
Robert Andrus-SVP West Region
So doesn't this mean these two either worked solely for FORBA and lent their name and dental licenses for business filings OR they owns the clinics in Kentucky as well as work for the company that so called 'manages" those clinics.
That being the case, should it not be these three, (Ken Knott, Bob Andrus, and Jodi Kuhn suing me in Federal Court instead of the company that just 'manages' the clinics for them?
But wait, according to the trademark office, FORBA Holding owns the rights to the Small Smiles logo. Boy this sure is confusing isn't it.


update: 2-1-2010



Small Smiles of Louisville, PSC
Kentucky Organization Number: 0662918
Formed 4-24-2007 By Jodi Kuhn
Name and address of Original Shareholder:
Jodi Kuhn
5615 Sarah's Oak Drive
Cincinnati, OH 45248

Name and address of Incorporator:
Jodi Kuhn
5615 Sarah's Oak Drive
Cincinnati, OH 45248

Mailing Address of Principal Office:
415 N. Grand Ave
Pueblo, CO 81003
Status-Active
Standing-Good
File Date-4/24/2007
Last Annual Report-6/17/2009
Principal Office: - 415 N. Grand Ave, Pueblo, Colorado 81003 (isn't that FORBA's address in Colorado...hmmm)
Registered Agent- CT Corporation System, 4169 Westport Road, Louisville, Kentucky 40207
Shares-1000
Corporate Officers:
President- Jodi Kuhn
Secretary-William Nash
Director-Jodi Kuhn
Shareholder-Jodi Kuhn
Incorporator-Jodi Kuhn
Assumed Names: Small Smiles Dental Centers of Louisville, Small Smiles Dental Clinic, Small Smiles Dental Clinic of Louisville.
(Note in 2009 report Dr. Robert F. Andrus and Dr. Kenneth E. Knott are no longer 'shareholders')
KY 2008 Annual Report
KY 2009 Annual Report
On June 25,2009 they finally changed the Principal Office address to FORBA Holding, LLC's address at 618 Church Street, Suite 520, Nashville, TN.

Ky Change of Principal Office 2009

___________________________________________________________________
Small Smiles Of Lexington, PCS
Kentucky Organization Number: 0673476

Formed 9-12-2007 By Dr. Kenneth E. Knott

Name and address of Original Shareholder:
Robert Andrus

1499 Blake Street

Denver, CO 80202

&
Kenneth Knott
7530 S. Biloxi Ct.
Aurora, CO 80016

Name and address of Incorporator:
Kenneth Knott
7530 S. Biloxi Ct.
Aurora, CO 80016
Mailing Address of Principal Office:
618 Church Street, Suite 520

Nashville, TN 37219
Organization Number-0673476
Status- Good
Standing- Active
File Date - 9/12/2007
Last Annual Report- 6/17/2009
Principal Office - 618 Church Street, Suite 520, Nashville, TN 37219

Registered Agent- National Registered Agent, 400 West Market Street, Suite 1800, Louisville, Kentucky.
Authorized Shares- 1000
Current Officers:
President- Jodi Kuhn

Secretary-William Nash
Director-Jodi Kuhn

Director-William Nash

Shareholder-Jodi Kuhn

Assumed Names:
Small Smiles Dental Center
Small Smiles Dental Centers of Lexington
(Note in the 2009 report Dr. Robert F. Andrus and Dr. Kenneth E. Knott are no longer 'shareholders' or 'directors')
KY 2008 Annual Report
KY 2009 Annual Report





Looks like Dr. Jodi Kuhn has laid a hell of a lot on the line for FORBA Small Smiles House of Horrors.

Kansas TV Station Looks Into Small Smiles

Families Concerned About Small Smiles

Posted: March 17, 2009 03:40 PM

Updated: March 17, 2009 09:30 PM

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

More Company Response:

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

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

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


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


________________________________________

This blogger's Comments:

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

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

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

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

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

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

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


Whistleblower:

Thursday, March 19, 2009

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

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

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


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


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

Update:

STATEMENT FROM SMALL SMILES DENTAL CLINIC OF WICHITA

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

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

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

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





________________________________________________
This blogger's comment:

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

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

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

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

Monday, March 09, 2009

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

 

March 09, 2009 10:06 PM

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

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

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

Friday, March 06, 2009

Colorado Springs Gazette Mentions 20/20 Probe

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

 

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

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

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

Wednesday, March 04, 2009

I found the following over at "American Thinker".

By Brian Riley:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I wonder how that job interview went:

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

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

Reply: "Great! When can you start?"

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

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

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

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

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


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

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





Thursday, February 26, 2009

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

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

 

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

 

 

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

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

Tuesday, February 24, 2009

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

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

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

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

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

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

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

Tuesday, February 17, 2009

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Brian and Greg:

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

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

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

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

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

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

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

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

Bruce Duty of Red River wrote back within minutes:

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

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

What Now for the State’s Small Smiles Investment?

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

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

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

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

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

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

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

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

Monday, January 26, 2009

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

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

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

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

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

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

I would also like to offer this:

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

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

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

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

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

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

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

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

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

Sincerely,

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

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

________________________________________

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

_________________________________________

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