A bureau worker who brought dentistry to nursing homes managed to grow his company to 10,000 patients in 68 homes before a state close him down for violating a key tenet in safeguarding doctor-patient relationships: Only dentists can own a dental practice. That 2010 "cease as well as desist" order from a state dental house didn't keep him sealed for long, though. Within 3 months, Kenneth Kucera registered a new operation under a new name with a cabinet member of state's office. This time, he filed as a nonprofit, using an exemption in state law that lets a non-dentist own a dental practice. A year as well as a half later, a new classification has nonetheless to file office work looking capitulation of a nonprofit status from a Internal Revenue Service, although it still has time under a two-year federal deadline. And The Denver Post has learned a Colorado Board of Dental Examiners is again investigating. The newspaper additionally found a company's lead dentist was hired even yet complaints about his caring during a previous job led to a dental board's placing him upon a two-year probation. The re-emergence of Visiting Ancillary Services, formerly called HomeCare Dental Services, raises questions about a oversight of dentistry in nursing homes, a struggle to find dentists peaceful to use in those facilities as well as a strength of Colorado law to guard opposite non-dentists running dental practices. The point of a law is to have sure doctors, not commercial operation owners, have decisions about patient care, pronounced Molly Pereira, join forces with executive executive of a Colorado Dental Association. "Their healing perspective should trump their commercial operation perspective when it comes to patient care," she said. Advertised as "the most appropriate non-profit, full-service visiting dental choice for a long-term caring industry," Visiting Ancillary Services boasts that a dentists can caring for patients "right in their wheelchairs." Kucera, who was owners of a former commercial operation as well as now is executive executive of a nonprofit version, pronounced any money a classification reaps by Medicaid reimbursement goes toward building a commercial operation by purchasing portable X-ray equipment as well as drills. Nursing homes have been lifeblood The classification bills Medicaid or other insurance without delay for a little procedures, but 80 percent of a revenue comes by nursing homes. Nursing homes collect Medicaid money from a state to cover residents' dental care, then compensate Kucera's organization. The state Department of Health Care Policy as well as Financing, that handles Medicaid disbursement, does not have a database that tracks how most of a open money went to Visiting Ancillary Services. Officials with a nonprofit estimated their current monthly revenues have been between $40,000 as well as $70,000. The government insurance plan will reimburse $1,600 for a set of dentures, for example. Visiting Ancillary Services can do a work for $900, Kucera said. That $700 in profit is used to further a mission of a organization, he said. Nonprofits have been required to file annual office work with a IRS showing revenues, losses as well as salaries. Many post a forms upon their websites. Visiting Ancillary Services' accountant pronounced she would file that form during a end of a year but did not have financial details available final week. The former company was bringing in $1.5 million in annual revenue when a dental house ordered it to close down, Kucera said. After about 10 years as well as pouring in $400,000 out of his pocket to build a company, it had become successful. In a final year, Kucera eventually drew a income $90,000. "We had about 10,000 patients who were basically, by a dental board, abandoned," he said. The nonprofit already has contracts with 26 nursing homes in a Denver as well as Fort Collins areas as well as plans to expand to 50 within another year. Eventually, Kucera wants to add ear as well as eye exams to a dental operation. Kucera pronounced his motives have been altruistic to help an underserved population. And he says his troubles with a dental house have been a result of complaints by a competing dentist angered by Kucera's success. "It sounds strange that people actually wish to do a right thing," he said. Kucera pronounced his former company was never a dental practice; it was a "dental scheduling" business. Board members upon payroll Reviving a company as a nonprofit classification required a creation of a new structure, including a house of directors who act as advisers. But half of a six-member house has a financial seductiveness in a company's success, a conflict of seductiveness avoided by other nonprofits interviewed by The Post. Kucera is upon a board. The house authority is Greg Kowalchuk, who additionally acts as a organization's lead dentist a contract employee paid hourly to yield dental care. Another dentist who has worked for a commercial operation as well as is likely to again as a classification contracts with additional nursing homes is a house member. Kucera pronounced he eventually expects a classification will elect a house authority who is not upon a payroll. The nonprofit's accountant, Patricia Hecht, was named as a house member when a company was formed but later stepped down. Other dental charities differ No members of a house of directors for Dental Lifeline Network, a nonprofit that sends a mobile section to 20 Colorado nursing homes, have been paid by a organization, pronounced Melissa Bosworth, vice president of affiliate operations. Dental Lifeline is recognized by a IRS as a nonprofit as well as gets a majority of funding for a nursing home module from a state health dialect grant. Another nonprofit operating in Colorado, Kids in Need of Dentistry, has 3 clinics as well as a bus that brings dental caring to schools as well as communities. The classification is funded by Medicaid reimbursements as well as about $400,000 in annual donations. Its house members have been volunteers; none is paid to work for a nonprofit. The two dentists who work for Visiting Ancillary Services have been paid hourly. Organization officials declined to say how most they have been paid, except to say it is less than what general use dentists have per hour. Kowalchuk, a organization's lead dentist as well as house chairman, was placed upon a two-year trial by a state dental house in 2008. He was allowed to yield dental caring to nursing home residents under a supervision of a monitor, who reviewed his patient files as well as made random spot checks of his work, Kucera said. "He passed with flying colors," he said. His probationary period expired in 2010. Dental caring hard to find It's difficult, as well as in rural areas nearly impossible, to find competent dentists peaceful to yield residents with dementia as well as disabilities inside nursing homes, pronounced Shelley Hitt, a state long-term caring ombudsman during a Legal Center for People With Disabilities as well as Older People. The profit domain is small as well as a work is challenging dentists often have been bitten by confused patients scared that a stranger is sticking instruments in their mouth. "To find competent dentists who have been ready, peaceful as well as able as well as fervent to yield this kind of caring ... there aren't many options," Hitt said. Nursing homes as well as residents' kin should have sure dentists providing caring have been qualified. Nursing home directors contacted by The Post declined to comment. Several complaints to a dental house regarding Kucera's commercial operation as well as now a nonprofit came from Dr. Donald Connor, a Denver dentist who works in nursing homes. Connor additionally has sent letters to nursing home directors revelation them about Kucera's trouble with a dental board. Complainant's work focus Connor called nursing home commercial operation his "livelihood" as well as pronounced homes should hire a "reputable dentist," not a businessman. In an October minute obtained by The Post, a dental house informed Connor's wife that "after careful consideration," a house was conducting a formal investigation of Visiting Ancillary Services. Dental house module executive Maulid Miskell pronounced he could not confirm a existence of any ongoing investigation. In general, when a house is determining whether a non-dentist is running a dental practice, it considers exemptions in law, such as a one for nonprofits, he said. In Colorado, neither a cabinet member of state's bureau nor a Department of Revenue is required to follow up to see whether an entity that filed as a nonprofit is acting as a nonprofit. It is up to a classification to file a required application for nonprofit status with a IRS. Hecht, Visiting Ancillary Services' accountant, pronounced she is preparing a documents. Jennifer Brown: 303-954-1593 or jenbrown@denverpost.com
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