Kool Smiles
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Kool Smiles is a dental services provider, based in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
. Its headquarters are in the Kool Smiles Patient Support Center in Marietta,
Georgia Georgia most commonly refers to: * Georgia (country), a country in the Caucasus region of Eurasia * Georgia (U.S. state), a state in the Southeast United States Georgia may also refer to: Places Historical states and entities * Related to the ...
, U.S., in
Greater Atlanta Metro Atlanta, designated by the United States Office of Management and Budget as the Atlanta–Sandy Springs–Alpharetta, GA Metropolitan Statistical Area, is the most populous metropolitan statistical area in the U.S. state of Georgia and the ...
and has over 100 offices located across sixteen states. Kool Smiles operates dental clinics located in low-income communities. Kool Smiles positions itself as a general dentistry that treats both children and adults. The company recruits for general dentists, pediatric dentists, endodontists and oral surgeons. Kool Smiles provides preventive care, diagnostic imaging and restorative care supported by electronic health records, as well as the free curriculum on oral health and dental care. In 2018, a number of Kool Smiles clinics were rebranded after the company was forced to pay $23.9 million to settle federal charges of Medicaid fraud and was sued over the death of 2-year-old Zion Gastelum at an Arizona clinic.


History

In August 2002, the first Kool Smiles location opened in East Lake,
Atlanta Atlanta ( ) is the capital and most populous city of the U.S. state of Georgia. It is the seat of Fulton County, the most populous county in Georgia, but its territory falls in both Fulton and DeKalb counties. With a population of 498,715 ...
, in DeKalb County,Stirgus, Eric.
Kids all smiles at DeKalb clinic Dental center filled with toys, murals
" '' Atlanta Journal-Constitution''. November 29, 2002. D3. Retrieved on January 26, 2012.
near the
city of Decatur The ''Blue Bird'' was a streamlined passenger train operated by the Wabash Railroad and its successor the Norfolk and Western Railway between Chicago, Illinois, and St. Louis, Missouri. It operated from 1938 to 1971. Beginning in 1950 it was one ...
. The clinic only accepted patients on
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...
and
PeachCare PeachCare for Kids is a low-cost health insurance program for children of uninsured, low-income families in the U.S. state of Georgia (U.S. state), Georgia who do not qualify for Medicaid. It is operated by the Georgia Department of Community Healt ...
, Georgia's state insurance program. Brown said "The demand for service was unbelievable. These kids had nowhere to go for years and years." Brown said that originally they planned to open ten to fifteen clinics. By 2005, Kool Smiles had opened six clinics in Georgia and two in Indianapolis, Indiana, and it had plans to open new clinics in Massachusetts and Virginia. It accepted patients on
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...
and state insurance plans and patients who did "self-pay". They did not accept private insurance. In 2007, it had 10 clinics in Georgia. Around that year, it served 71,000 children annually at its Georgia clinics. In 2008, the chain had about 40 clinics in seven U.S. states. In 2009 it operated 84 clinics in the entire United States. After the WellCare and Peach State Medicaid networks followed through with plans to terminate Kool Smiles from their contracts, patients of Kool Smiles and another company filed an injunction that would prevent the terminations until WellCare and the Peach State organizations would show that the ending of the contracts would not contradict Medicaid dental program requirements. Kool Smiles' Chief Dental Officer, Dr. David Strange, argued that if it lost the contract, some families in
Columbus, Georgia Columbus is a consolidated city-county located on the west-central border of the U.S. state of Georgia. Columbus lies on the Chattahoochee River directly across from Phenix City, Alabama. It is the county seat of Muscogee County, with which it ...
, would be unable to receive dental care. Kool Smiles remained part of the Amerigroup Medicaid network and later resumed participation in the WellCare and Peach State Medicaid networks. Kool Smiles currently participates in all of the Medicaid networks in Georgia. Kool Smiles has partnered with the Gary Community Health Center and the East Chicago Community Health Center to provide dental care in their facilities. The company has also partnered with the Governor of Maryland, Martin O'Malley, on his "Healthy Smiles Tour" to improve access to dental care in the state. In 2010 Kool Smiles generated $80 million in earnings before interest, taxes, depreciation and amortization (EBITDA). During that year the company hired Harris Williams, an investment bank, in order to sell itself. The company was said to be worth $700 million. As of October 4, 2010,
American Securities LLC American Securities LLC (originally named American Securities Capital Partners (ASCP)), is an American private equity firm based in New York with an office in Shanghai that invests in market-leading North American companies with annual revenues ge ...
was the lead bidder.Alesci, Cristina, Jeffrey McCracken, and Jason Kelly.
American Securities Said to Be in Lead to Buy Kool Smiles Chain
"

''
Bloomberg Bloomberg may refer to: People * Daniel J. Bloomberg (1905–1984), audio engineer * Georgina Bloomberg (born 1983), professional equestrian * Michael Bloomberg (born 1942), American businessman and founder of Bloomberg L.P.; politician and m ...
''. Retrieved on October 1, 2012.
The deal failed and the company was not sold.


Medicaid fraud allegations and settlement

In 2012, '' Frontline'' aired a report saying that Kool Smiles inappropriately used crowns on young patients instead of regular fillings, because Medicaid bills more for crowns, and that the company pressured dentists to go along with the usage of crowns to make more money for the company.Heath, David (Center for Public Integrity) and Jill Rosenbaum (Frontline).
Complaints About Kids Care Follow Kool Smiles
" '' Frontline''. June 26, 2012. Retrieved on August 5, 2012.
Kool Smiles responded by saying that, "Dentists do not receive revenue, patient or procedure targets or scorecards." Kool Smiles pointed to a study authored by presidential economist
Arthur Laffer Arthur Betz Laffer (; born August 14, 1940) is an American economist and author who first gained prominence during the Reagan administration as a member of Reagan's Economic Policy Advisory Board (1981–1989). Laffer is best known for the La ...
, which reviewed Texas Medicaid claims data and concluded that, in 2011, Kool Smiles charged less and performed fewer procedures, including crowns, per patient than other Medicaid dental providers in the state. The company said, "Unfortunately, ''Frontline'' ignores what all dentists know – children with long-neglected dental needs require more medical care." Later it was revealed ''Frontline'' had used a former employee as a source who was a convicted felon, who was suing the company after being terminated for allegedly falsifying documents. In response, Frontline acknowledged that their analysis showed that Kool Smiles provided 25% fewer crowns per patient (2.1 vs. 2.8) than the average dentist, but maintained that "patients going to Kool Smiles were twice as likely on average to get crowns" in Virginia, and 50% more likely in Texas. Around the same time, a number of studies were carried out regarding the adoption of
Dental Service Organizations Dental Service Organizations, known in the industry as "Dental Support Organizations" or abbreviated to DSOs, are independent business support centers that contract with dental practices in the United States. They provide business management and s ...
for many states. As one of the leading providers of DSOs in the United States, Kool Smiles' statistics were regularly quoted during this period. The result of regular care through DSOs meant that Kool Smiles' patients had an overall average monthly
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...
expenditure that was 33% lower than non-Kool Smiles patients and that Kool Smiles providers perform 15 percent fewer procedures per patient. In January 2018, Kool Smiles agreed to pay $23.9 million to settle Medicaid fraud charges. The federal government alleged that the company filed false claims for unneeded dental procedures performed on children, including tooth removals,
pulpotomies Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved unders ...
, and installing stainless steel crowns. The company was also accused of billing for services it did not actually render.


Death of Zion Gastelum and rebranding

Zion Gastelum, 2, died four days after a December 2017 visit to a Kool Smiles dental clinic in Yuma, Arizona, where he became unresponsive after being placed under anesthesia by Dr. Aaron Roberts. Zion's parents subsequently sued Kool Smiles and Roberts. The plaintiffs alleged that the procedure, which included six root canals and crowns as well as a "cosmetic" enameloplasty, was unnecessary and performed "without truly informed consent from the parents". In addition, the suit claimed that "a Kool Smiles staff member silenced the alarm on the pulse oximeter, which is used to monitor a patient's pulse and oxygen saturation", and that "Zion was left alone in the recovery room and an oxygen tank Zion was hooked up to was either empty or not working properly." Zion's was the second death of a child linked to the same dental office, which subsequently rebranded as Manzana Dental, as part of a larger rebranding of many Kool Smiles clinics. Other rebranded Kool Smiles clinics include Cortland Dental (MA), Pippin Dental (IN), Elstar Dental (TX), Pinova Dental (TX), Jubilee Dental (TX), Creston Dental and Braces (SC), Pine Dental (MD & VA), Sutton Dental (CT), Taylor Dental (LA), Ruby Dental (KY), and Dorsett Dental (AZ).


Business & Services

The company headquarters are located in the Kool Smiles Patient Support Center in Suite 290 of the Northchase Office Park building in Marietta,
Georgia Georgia most commonly refers to: * Georgia (country), a country in the Caucasus region of Eurasia * Georgia (U.S. state), a state in the Southeast United States Georgia may also refer to: Places Historical states and entities * Related to the ...
, U.S., in
Greater Atlanta Metro Atlanta, designated by the United States Office of Management and Budget as the Atlanta–Sandy Springs–Alpharetta, GA Metropolitan Statistical Area, is the most populous metropolitan statistical area in the U.S. state of Georgia and the ...
.Sams, Douglas. "Campanile may be renamed 1155 Peachtree." ''
Atlanta Business Journal American City Business Journals, Inc. (ACBJ) is an American newspaper publisher based in Charlotte, North Carolina. ACBJ publishes The Business Journals, which contains local business news for 44 markets in the United States, Hemmings Motor News ...
''. Monday, March 22, 2010. Last modified Thursday, March 18, 2010.
4
Retrieved on October 1, 2012.
At one time its headquarters were in Suite 440 of Building 400 of the Atlanta Technology Center in
Atlanta Atlanta ( ) is the capital and most populous city of the U.S. state of Georgia. It is the seat of Fulton County, the most populous county in Georgia, but its territory falls in both Fulton and DeKalb counties. With a population of 498,715 ...
. At a later time its headquarters were in Suite 800 of the Galleria 400 building in
unincorporated Unincorporated may refer to: * Unincorporated area, land not governed by a local municipality * Unincorporated entity, a type of organization * Unincorporated territories of the United States, territories under U.S. jurisdiction, to which Congress ...
Cobb County Cobb County is a county in the U.S. state of Georgia, located in the Atlanta metropolitan area in the north central portion of the state. As of 2020 Census, the population was 766,149. Its county seat and largest city is Marietta, Georgia, Mar ...
. In 2011, two million patients visited Kool Smiles clinics.Freedberg, Sydney P.
Dental Abuse Seen Driven by Private Equity Investments
" ''
Bloomberg Bloomberg may refer to: People * Daniel J. Bloomberg (1905–1984), audio engineer * Georgina Bloomberg (born 1983), professional equestrian * Michael Bloomberg (born 1942), American businessman and founder of Bloomberg L.P.; politician and m ...
''. May 17, 2012. Retrieved on September 12, 2012. "U.S. Senate investigators are examining whether ReachOut, Church Street, and its affiliated clinics have overbilled Medicaid, according to Senate documents and people familiar with the matter. Another company under Senate scrutiny is NCDR LLC, which manages 130 Kool Smiles clinics, these people say."
Kool Smiles is a
privately held company A privately held company (or simply a private company) is a company whose shares and related rights or obligations are not offered for public subscription or publicly negotiated in the respective listed markets, but rather the company's stock is ...
with over 1000 employees reported in October, 2011 Kool Smiles has provided more than $100 million in free care to poor children and their families since 2005. May 15, 2016 is "Sharing Smiles Day

the annual day on which Kool Smiles locations offer free care to uninsured children under the age of 1

http://www.richmond.com/life/health/article_9b88c408-e722-52d4-b637-9f0b46c7ba2a.htm

http://www.centralctcommunications.com/newbritainherald/article_88dff81a-1582-11e6-a956-7fafe16f8d97.html]


Statistics

During 2008, Kool Smiles treated 18,000 children in the
Georgia Georgia most commonly refers to: * Georgia (country), a country in the Caucasus region of Eurasia * Georgia (U.S. state), a state in the Southeast United States Georgia may also refer to: Places Historical states and entities * Related to the ...
area, whose families had no medical insurance. The check-ups came as part of a government initiative, with the treatment being the first dental treatment the children had received in many cases. By 2011, two million patients visited Kool Smiles clinics. As part of Kool Smiles' work in
South Carolina )'' Animis opibusque parati'' ( for, , Latin, Prepared in mind and resources, links=no) , anthem = " Carolina";" South Carolina On My Mind" , Former = Province of South Carolina , seat = Columbia , LargestCity = Charleston , LargestMetro = ...
, the percentage of Medicaid-enrolled children receiving dental services increased from 46.9 percent to 51.9 percent. The statistics were announced in 2011 when the dental practice opened its seventh clinic in the state. A study conducted in 2015 by Dobson DaVanzo concluded states could save more than $550 million annually in Medicaid expenditures provided care as conservatively as Kool Smiles, which does 25% fewer services at a 37% lower cost than others providing care to the same patient population.


See also

* All Smiles Dental Centers *
Aspen Dental Aspen Dental Management, Inc. (ADMI) is an American dental support organization (DSO), a dental practice management corporation that provides business support and administrative services in the US. Its headquarters is in Chicago, Illinois. Hist ...
*
Medicaid Dental Center Smile Starters Dental, formerly Medicaid Dental Center (MDC), is a chain of dental clinics in North Carolina. As MDC, it operated under the names Smile Starters and Carolina Dental Center.Beeker, Ladonna.Dentist closes clinic"Archive '' The Observe ...
* ReachOut Healthcare America * Small Smiles Dental Centers *
Delta Dental The Delta Dental Plans Association is a network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 mill ...


References


Further reading

*
Wellcare Assures Medicaid Members of Access to Quality Dentists/DCH Statement Concerning Possible Class Action Lawsuit Regarding Medicaid Dental Services

Archive
"
Archive
Wellcare of Georgia. *

" (Declaration of Peter Clay) {{Atlanta companies Dental companies of the United States Companies based in Cobb County, Georgia Marietta, Georgia Companies based in Atlanta Health care companies based in Georgia (US State) 2002 establishments in Georgia (U.S. state)