Kool Smiles

Kool Smiles Houston-Aldine dental clinic in unincorporated Harris County, Texas

Kool Smiles, PC is a for-profit^[2] dental services provider with its headquarters in the Kool Smiles Patient Support Center in Marietta, Georgia, U.S., in Greater Atlanta.

Kool Smiles operates dental clinics located in low income communities. In 2011, Kool Smiles had over 100 offices located in 17 states nationwide. 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 preventative care, diagnostic imaging and restorative care supported by electronic health records.

History

A former paramedic and private ambulance service head named Doug Brown decided to start NCDR, a dental services organization (DSO) after he had experience working with his brother in law, who was treating Medicaid patients in a dental practice. According to Brown, starting NCDR would allow him to help children who need care and to establish a viable business.^[3] Brown contracted with two dentists from Denver, Colorado with their practice called Kool Smiles.^[3] In August 2002, the first Kool Smiles location opened in East Lake, Atlanta, in DeKalb County,^[4] near the city of Decatur.^[2] The clinic only accepted patients on Medicaid and PeachCare, Georgia's state insurance program.^[4] Brown said "The demand for service was unbelievable. These kids had nowhere to go for years and years."^[3] Brown said that originally they planned to open ten to fifteen clinics.^[3]

In 2004 Brown received a telephone call from Friedman Fleischer & Lowe (FFL), a private equity firm. The company had originally planned to purchase a different Medicaid dental chain, but FFL instead decided that it would form its own chain. Brown said that, as paraphrased by David Heath of the Center for Public Integrity, that the selection by FFL "was a million-to-one shot".^[3] Heath wrote in a Frontline program that "the initial investment was small by private-equity standards."^[3]

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 and state insurance plans and patients who did "self pay". They did not accept private insurance.^[2] In 2007, it had 10 clinics in Georgia.^[5] Around that year, it served 71,000 children annually at its Georgia clinics.^[6] In 2008, the chain had about 40 clinics in seven U.S. states.^[7] In 2009 it operated 84 clinics in the entire United States.^[8]

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.^[3] Kool Smiles responded by saying that, "Dentists do not receive revenue, patient or procedure targets or scorecards."^[9] Kool Smiles pointed to a study authored by presidential economist Arthur Laffer, 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.^[10] The company said, "Unfortunately, Frontline ignores what all dentists know – children with long-neglected dental needs require more medical care."^[11]

Overview

The company says that its mission is to provide quality dental care for children and families in underserved communities. In 2011, two million patients visited Kool Smiles clinics.^[12] Kool Smiles is a privately held company with over 1000 employees reported in October, 2011^[13] Kool Smiles accepts all forms of insurance and payment including: employer based insurance, Medicaid, State Children's Health Insurance Program (SCHIP) and TRICARE.^[14]

Kool Smiles contracts with NCDR LLC, a dental service organization that provides non-clinical administrative and management support services. NCDR is privately held and invested in by Friedman Fleischer & Lowe. Kool Smiles is NCDR’s primary client.^[14] NCDR, which does business as "Kool Smiles,"^[15][16] has its headquarters in the same Marietta, Georgia, office suite that houses Kool Smiles. NCDR was incorporated in 2001. NCDR provides dental facilities, support staff members and dental services that are not clinical to dental clinics.^[17] In a letter U.S. Senator Chuck Grassley said "Records indicate that NCDR, LLC., may have a financial interest in Kool Smiles practices."^[18]

Corporate affairs

The company headquarters are located in the Kool Smiles Patient Support Center in Suite 290 of the Northchase Office Park building in Marietta, Georgia, U.S., in Greater Atlanta.^[19][17] At one time its headquarters were in Suite 440 of Building 400 of the Atlanta Technology Center in Atlanta.^[20][21] At a later time its headquarters were in Suite 800 of the Galleria 400 building in unincorporated Cobb County.^[17][22][23] In 2010 NCDR, LLC announced that it had leased 39,869-square-foot (3,704.0 m²) of space in the Northchase Office Park and that it was moving there from Galleria 400.^[17]

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.^[24] The company was said to be worth $700 million.^[3] As of October 4, 2010, American Securities LLC was the lead bidder.^[25] The deal failed and the company was not sold.^[3]

Partnerships

Kool Smiles has partnered with the Gary Community Health Center and the East Chicago Community Health Center to provide dental care in their facilities.^[26] 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.^[27]

Legal

Kool Smiles Lawsuit: (August–September 2007) 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 a lawsuit asking for an injunction that would prevent the terminations until WellCare and the Peace State organizations would show that the ending of the contracts would not contradict Medicaid dental program requirements.^[28] Kool Smiles' chief dental officer, Dr. David Strange, argued that if it lost the contract, some families in Columbus, Georgia, would be unable to receive dental care. Dr. Vanessa Downer, the West Central Health District director, stated that the City of Columbus had a full service municipal dental facility for children and that the Columbus facility would be ready to accept some Kool Smiles patients if the clinic did close.^[29]

Kool Smiles remained part of the Amerigroup Medicaid network and is currently part of the Amerigroup, WellCare, and Peach State networks in Dalton and Columbus.^[30]

See also

• All Smiles Dental Centers
• Aspen Dental
• Medicaid Dental Center
• ReachOut Healthcare America
• Small Smiles Dental Centers
• South Texas Dental
• Delta Dental

Further reading

• "WELLCARE ASSURES MEDICAID MEMBERS OF ACCESS TO QUALITY DENTISTS/DCH Statement Concerning Possible Class Action Lawsuit Regarding Medicaid Dental Services." (Archive) Wellcare of Georgia.
• "CIVIL ACTION FILE No. 4:07-cv-00167." (Declaration of Peter Clay)

External links

• Kool Smiles Website (Alternate link)
• NCDR
• "NCDR." Friedman Fleischer & Lowe. (Archive)

References