Small Smiles Dental Centers
Encyclopedia
Small Smiles Dental Centers is a privately owned US chain of dental clinics focused on serving children from low-income families. Small Smiles has 70 centers located in 22 states and Washington, D.C., and says that it serves hundreds of thousands of children annually.
In January 2010, it gained national attention when Small Smiles' parent organization, Forba Holdings LLC, settled False Claims Act
allegations with the United States Department of Justice
. As of January 1, 2011 FORBA Holdings, LLC changed its name to Church Street Health Management (CSHM).
In 2000, FORBA, LLC (FOR Better Access) was formed, providing dental care to children across the United States. By 2006, 47 Small Smiles and other associated practices such as Children’s Dental Clinic in Gary Indiana, Indian Springs Dental Clinic in Oklahoma and Topeka Dental Clinic, Topeka, Kansas had opened in 16 states.
In September and October 2006 the assets of Forba Dental Management aka FORBA, LLC were acquired from the DeRose family by a group of investors led by the Carlyle Group
, Arcapita Bank
, and American Capital Strategies
. Sanus Holdings, LLC was created for purchasing FORBA, LLC's assets. Sanus Holdings later became Small Smiles Holding Company, LLC. The sales price was reported to be $435 million dollars. A revolving line of credit was opened by CIT Group. and the operation relocated to Nashville, Tennessee.
Currently operating under a corporate integrity agreement with the U.S. Department of Health and Human Services, Church Street's network of associated dental centers continues to serve low-income families, and recently began opening new clinics and featuring new services such as orthodontics and adult care.
Members of the Pediatric Dental Advisory Board include Dr. Paul Casamassimo, Chair of the Department of Pediatric Dentistry at Ohio State University and Chief of Dentistry at Nationwide Children’s Hospital; Dr. Joe Bernat, Chair of the Department of Pediatric and Community Dentistry at the State University of New York-Buffalo School of Dental Medicine; Dr. Arthur Nowak
Professor Emeritus at the University of Iowa Colleges of Dentistry and Medicine; and Dr. Anupama Tate Director of Pediatric Dentistry at Children’s National Medical Center in Washington, D.C.
. The suit was dismissed on April 16, 2009 at FORBA's request.
On September 28, 2009 a lawsuit was filed by FORBA Holdings, LLC against the company's former owners (LICSAC, LLC, DD Marketing, Inc., DeRose Management, LLC and LICSAC NY, LLC), citing breach of contract. On February 26, 2010 the case was dismissed.
In January 2010, the US Justice Department settled False Claims Act
allegations against FORBA Holdings, LLC. Under the settlement, FORBA will pay $24 million plus interest to the US and several states. The investigation was spurred by three qui tam
lawsuits filed by former employees in Maryland, Virginia and South Carolina in late 2007 and early 2008. The US Justice Department found that FORBA was liable for:
Under the agreement, “FORBA has agreed to enter into an expansive five-year Corporate Integrity Agreement with the Office of the Inspector General of the Department of Health and Human Services. The agreement provides for procedures and reviews to be put in place to avoid and promptly detect conduct similar to that which gave rise to this matter.” Investigations into individual dentists continue with the company's cooperation.
In response, company chairman and CEO Michael Lindley posted a statement on the firm’s website stating “…We entered into the settlement to avoid the delay, uncertainty, inconvenience and expense of litigation, and did not admit any liability.”
On January 25, 2010, just days after the settlement was announced, a class action
suit was filed in the U.S. District Court for the Northern District of Ohio.
In January 2010, it gained national attention when Small Smiles' parent organization, Forba Holdings LLC, settled False Claims Act
False Claims Act
The False Claims Act is an American federal law that imposes liability on persons and companies who defraud governmental programs. The law includes a "qui tam" provision that allows people who are not affiliated with the government to file actions on behalf of the government...
allegations with the United States Department of Justice
United States Department of Justice
The United States Department of Justice , is the United States federal executive department responsible for the enforcement of the law and administration of justice, equivalent to the justice or interior ministries of other countries.The Department is led by the Attorney General, who is nominated...
. As of January 1, 2011 FORBA Holdings, LLC changed its name to Church Street Health Management (CSHM).
History
Small Smiles began with a dental office that was opened in 1928 in Pueblo, Colorado. The original owners, Dr. Edward DeRose, Dr. Michael DeRose, Dr. William Muller, Dr. Adolph Padula and Dan DeRose, later built four more offices in Colorado and New Mexico in the 1990s.In 2000, FORBA, LLC (FOR Better Access) was formed, providing dental care to children across the United States. By 2006, 47 Small Smiles and other associated practices such as Children’s Dental Clinic in Gary Indiana, Indian Springs Dental Clinic in Oklahoma and Topeka Dental Clinic, Topeka, Kansas had opened in 16 states.
In September and October 2006 the assets of Forba Dental Management aka FORBA, LLC were acquired from the DeRose family by a group of investors led by the Carlyle Group
Carlyle Group
The Carlyle Group is an American-based global asset management firm, specializing in private equity, based in Washington, D.C. The Carlyle Group operates in four business areas: corporate private equity, real assets, market strategies and fund-of-funds, through its AlpInvest subsidiary...
, Arcapita Bank
Arcapita
Arcapita Inc. is a Delaware-incorporated holding and real estate company, headquartered in Atlanta, Georgia....
, and American Capital Strategies
American Capital Strategies
American Capital is an alternative asset management company based in Bethesda, Maryland. Founded in 1986 and publicly traded since 1997, American Capital is the largest U.S. publicly traded private equity fund and one of the largest publicly traded alternative asset managers...
. Sanus Holdings, LLC was created for purchasing FORBA, LLC's assets. Sanus Holdings later became Small Smiles Holding Company, LLC. The sales price was reported to be $435 million dollars. A revolving line of credit was opened by CIT Group. and the operation relocated to Nashville, Tennessee.
Currently operating under a corporate integrity agreement with the U.S. Department of Health and Human Services, Church Street's network of associated dental centers continues to serve low-income families, and recently began opening new clinics and featuring new services such as orthodontics and adult care.
Quality Initiatives
After the ownership change in 2006, Small Smiles and its various clinics have pledged to be compliant with standards set in state and federal healthcare guidelines, as well as guidelines from the American Academy of Pediatric Dentistry. A Pediatric Dental Advisory Board was established in 2007 to assist Chief Dental Officer Dr. Stephen Adair in meeting quality of care standards.Members of the Pediatric Dental Advisory Board include Dr. Paul Casamassimo, Chair of the Department of Pediatric Dentistry at Ohio State University and Chief of Dentistry at Nationwide Children’s Hospital; Dr. Joe Bernat, Chair of the Department of Pediatric and Community Dentistry at the State University of New York-Buffalo School of Dental Medicine; Dr. Arthur Nowak
Professor Emeritus at the University of Iowa Colleges of Dentistry and Medicine; and Dr. Anupama Tate Director of Pediatric Dentistry at Children’s National Medical Center in Washington, D.C.
Legal action
On November 14, 2008 FORBA Holdings, LLC brought a lawsuit against one its biggest critics, Debbie Hagan, who runs a blog devoted to exposing the abuses of Small Smiles and other dental mills, alleging copyright infringementCopyright infringement
Copyright infringement is the unauthorized or prohibited use of works under copyright, infringing the copyright holder's exclusive rights, such as the right to reproduce or perform the copyrighted work, or to make derivative works.- "Piracy" :...
. The suit was dismissed on April 16, 2009 at FORBA's request.
On September 28, 2009 a lawsuit was filed by FORBA Holdings, LLC against the company's former owners (LICSAC, LLC, DD Marketing, Inc., DeRose Management, LLC and LICSAC NY, LLC), citing breach of contract. On February 26, 2010 the case was dismissed.
In January 2010, the US Justice Department settled False Claims Act
False Claims Act
The False Claims Act is an American federal law that imposes liability on persons and companies who defraud governmental programs. The law includes a "qui tam" provision that allows people who are not affiliated with the government to file actions on behalf of the government...
allegations against FORBA Holdings, LLC. Under the settlement, FORBA will pay $24 million plus interest to the US and several states. The investigation was spurred by three qui tam
Qui tam
In common law, a writ of qui tam is a writ whereby a private individual who assists a prosecution can receive all or part of any penalty imposed...
lawsuits filed by former employees in Maryland, Virginia and South Carolina in late 2007 and early 2008. The US Justice Department found that FORBA was liable for:
“… causing the submission of claims for reimbursement for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. These services included performing pulpotomies (baby root canals), placing crowns, administering anesthesia (including nitrous oxide), performing extractions, and providing fillings and/or sealants.”
..."In this case, FORBA put greed and profits before the well-being of children," said Timothy J. Heaphy, U.S. Attorney for the Western District of Virginia. "It endangered the health and safety of innocent children and defrauded the taxpayer of millions of dollars. Today’s settlement addresses these egregious acts and sends a clear message that Medicaid fraud will be expeditiously addressed by this Department."
Under the agreement, “FORBA has agreed to enter into an expansive five-year Corporate Integrity Agreement with the Office of the Inspector General of the Department of Health and Human Services. The agreement provides for procedures and reviews to be put in place to avoid and promptly detect conduct similar to that which gave rise to this matter.” Investigations into individual dentists continue with the company's cooperation.
In response, company chairman and CEO Michael Lindley posted a statement on the firm’s website stating “…We entered into the settlement to avoid the delay, uncertainty, inconvenience and expense of litigation, and did not admit any liability.”
On January 25, 2010, just days after the settlement was announced, a class action
Class action
In law, a class action, a class suit, or a representative action is a form of lawsuit in which a large group of people collectively bring a claim to court and/or in which a class of defendants is being sued...
suit was filed in the U.S. District Court for the Northern District of Ohio.