Health district buys Atwater dental surgery center

Bloss Memorial Healthcare District has bought out a husband-and-wife team that for 15 years ran a dental surgery center that treats low-income children and severely disabled adults from Merced and Stanislaus counties.

Bloss paid $300,000 to buy out Dr. Lawrence Church and his wife, Michelle, who were partners in Central California Dental Surgicenter in the former Castle Air Force Base hospital, said Edward Lujano, the district’s chief executive officer.

The center’s employees were “let go” Dec. 31, Lujano said, though some were hired back this month. Bloss, the previous two-thirds owner, now fully owns and operates the surgery center. It has stopped accepting adult patients and will only serve children age 2 to 8, Lujano said.

The center treats children under anesthesia because they are too young or have too many cavities to be treated by regular dentists. About 250 low-income children, many with 10 or more cavities, have undergone procedures at the center each month. Lujano said around 60 patients a month have been referred to the Atwater facility from Stanislaus County.

Lujano said the center could serve disabled adults in the future but it will depend on reimbursements. “There is very little reimbursement for the adult population in this category,” he said.

The Churches, who ran the center since its beginning in 1999, did not respond to requests for comment. Their names have appeared in recent news reports about a dispute over patient authorizations between Health Plan of San Joaquin and dental surgery centers in the Northern San Joaquin Valley.

Lujano said the Churches decided to retire. He explained that an outside group of doctors asked about buying the facility last summer, precipitating talks with the Churches about the center’s future. The district board of directors approved the deal to purchase the Churches’ one-third stake in December.

“We have been challenged for so many years with the lack of reimbursements and the red tape involved with treating those children,” Lujano said.

Two long-term employees who worked closely with the Churches gave a different account. They said their former employers wanted to buy out the district during months of negotiations; Bloss officials ultimately demanded that they sell or be pushed out.

Tammy Colbert, the former nursing director who lost her job, said all of the center’s 28 employees were terminated. Colbert said she had raised concerns about doctors not wearing masks or gloves during procedures done on patients. In addition, she said, district officials did little to correct problems with high humidity in the operating rooms. Lower humidity was recommended to maintain sterile conditions.

“There were times the humidity and the room temperature were the same,” Colbert said. “We had to shut down the OR twice. Then the staff are sitting around and you are losing money.”

Lujano said the issues were addressed in operational and governance meetings. He said Colbert did not lose her job for speaking out. Officials decided that the Atwater center and a Stockton surgical facility, also owned by Bloss, will share a nursing director and other administrative staff to eliminate duplication, the CEO said.

Bloss owns two-thirds of Children’s Dental Surgery Center in Stockton. David Thompson, a central figure in the dispute with Health Plan of San Joaquin, is serving as administrator of the Stockton and Atwater facilities. Other employees will work at both centers. Lujano said he believed eight employees were rehired to work for Bloss.

Mary Sheehan, clinical director of Valley Mountain Regional Center, which administers services for disabled adults, said the agency was informed the Atwater center has new management and had stopped accepting adults. Valley Mountain referred adults with autism or cerebral palsy to the facility because they were unable to comply with dentists.

The decision leaves even fewer options for those patients. Valley Mountain has referred clients to a Sutter Health hospital in Sacramento, where a dental surgery program is expected to close due to financial challenges.

“Our problem is finding someone to serve our adult consumers who have severe needs,” Sheehan said. “We had someone that went 21/2 months with a severe abscess and finally got (the client) to an oral clinic at (University of California, San Francisco). It’s very hard to find a facility that will accept them.”

Lujano said that Health Plan of San Joaquin still is raising roadblocks to authorizing anesthesia dentistry for children. Since September, the plan has required extensive documentation showing patients need anesthesia or that behavioral modification was attempted to get them to cooperate with a dentist.

A state law requires Medi-Cal managed care health plans to make payments to the surgery centers for anesthesia and facility charges.

“We must get 300 to 400 referrals on a monthly basis under Health Plan of San Joaquin from dentists who say they can’t treat these children in their office,” Lujano said. “We submit them for authorization and most of the time they are denied.”

The Central California Alliance for Health authorizes the procedures for low-income kids in Merced County, though it took some persuasion after the managed-care plan began serving the county five years ago, Lujano said.

David Hurst, vice president of external affairs for Health Plan of San Joaquin, said it has not seen better compliance by surgery centers to document the medical necessity for anesthesia dentistry. The Salida Surgery Center is also embroiled in the dispute.

This story was originally published January 23, 2015 at 8:14 PM with the headline "Health district buys Atwater dental surgery center."