Arkansas Court of Appeals Upholds Letter of Reprimand Issued by Arkansas Nursing Board against Nurse Convicted of Misdemeanor Criminal Mischief

Case and Court: Best v. Arkansas State Board of Nursing, 2026 Ark. App. 9

Issue: Was nurse issued Letter of Reprimand by Arkansas Nursing Board entitled to have it rescinded?

Holding: No. Following judicial review under the Administrative Procedure Act, the court determined that the appellant nurse’s behavior justified the agency’s action.

Summary: On September 12, 2022, Emily Best was charged with aggravated assault against a family or household member, domestic battery, and criminal mischief (a Class A misdemeanor). While the first two charges were nolle prossed, the third, stemming from an allegation that she drove her car into her mother’s car, resulted in a plea and sentence of 12 months’ probation.

A few months after she pled guilty, the Board issued her a Letter of Reprimand (LOR). The letter asserted that it was doing so pursuant to its “sole authority” under Ark. Code Ann. § 17-87-309(a)(2) to “deny, suspend, revoke, or limit any license or privilege to practice nursing or certificate of prescriptive authority issued by the board or applied for in accordance with the provisions of this chapter or to otherwise discipline a licensee upon proof that the person . . . [i]s guilty of a crime or gross immorality[.]” Slip Op. at 2 (alteration in opinion). She thereafter requested a hearing.

Board investigator Udell Ward testified that Best received her license in 2017, that she self-reported the conviction during the 2023 license renewal cycle, that she has received no discipline other than the LOR, and thatit was standard Board procedure to issue an LOR for a Class A misdemeanor conviction.

Emily’s mother Charlotte testified that Emily lives with her due to her severe medical needs, which require day-to-day assistance. She stated that her own mother, who has dementia and whom Emily helps care for, also lives in the home. The incident happened during what she described as a “chaotic” time in the household when, in addition to the regular residents of the home, Emily’s brother was also there recovering from a surgery. On the night giving rise to the charges, Charlotte called police to respond to an incident in which her mother was screaming in the night. Though she was unaware of any specific medication issues Emily was experiencing that night, she nonetheless testified that Emily had had many adverse medication reactions over the years.

Emily testified that she suffered from a slew of medical conditions. She stated that her health deteriorated shortly after college ended, preventing her from ever actually working as a nurse professionally. She attributed the incident to a bad reaction to a medication she had recently been put on for muscle spasms and disclaimed any memory of the incident. She asserted that she pled due to the need to avoid a trial, the risk that the stress might have aggravated a deep vein thrombosis from which she suffered, and her belief that such a plea would not adversely affect her nursing license.

Best also supported her case with letters from physicians opining that the incident may have arisen due to medication she was on, a letter from a counselor stating that they had crafted a safety plan to prevent such incidents in the future, and a note from a social worker attesting to her good behavior over the several years Best had been her patient.

The Board upheld the LOR. She appealed under the Arkansas Administrative Procedure Act to the Boone County Circuit Court, which affirmed the Board’s decision. She then appealed to the Arkansas Court of Appeals.

The court stated the following concerning the standard of review:

Judicial review of decisions of the Arkansas State Board of Nursing is governed by the Arkansas Administrative Procedure Act (“APA”), codified at Arkansas Code Annotated sections 25-15-201 to -221 (Repl. 2024). Tarr v. Ark. State Bd. of Nursing, 2025 Ark. App. 195, 711 S.W.3d 799. Judicial review of administrative-agency decisions under the APA is limited in scope. Id. An agency decision may be reversed if the substantial rights of the petitioner have been prejudiced because the administrative findings, inferences, conclusions, or decisions are (1) in violation of constitutional or statutory provisions; (2) in excess of the agency’s statutory authority; (3) made upon unlawful procedure; (4) affected by other error or law; (5) not supported by substantial evidence of record; or (6) arbitrary, capricious, or characterized by abuse of discretion. Ark. Code Ann. § 25-15-212(h).

Slip Op. at 5. The court noted that its review is directed to the agency decision, not the circuit court’s, and that “it is limited to determining whether any substantial evidence supports the agency decision or whether the agency decision runs afoul of one of the other criteria in section 25-15-212.” Id. (citation omitted).

The burden facing a party seeking to overturn a decision due to a lack of evidence is a high one:

Substantial evidence is defined as valid, legal, and persuasive evidence that a reasonable mind might accept as adequate to support a conclusion and forces the mind to pass beyond conjecture. The burden of proving an absence of substantial evidence is on the challenging party and requires a demonstration that the proof before the administrative agency was so nearly undisputed that fair-minded persons could not reach its conclusion. Witness credibility and the weight of the evidence are within the agency’s discretion, and it is the prerogative of the agency to believe or disbelieve any witness and to decide what weight to accord to that evidence. Once substantial evidence is found, it automatically follows that an agency decision cannot be classified as unreasonable or arbitrary.

Slip Op. at 6 (citations omitted).

Best made four arguments on appeal:

·The LOR exceeds the Board’s authority because her criminal-mischief conviction is not within the scope of “crimes” over which the Board can exercise disciplinary authority.

·LOR relies on the vague and generic term “gross immorality.”

·The Board illegally considered nolle prossed charges in issuing the LOR.

·Alternatively, the Board’s issuance of the LOR was unduly harsh.

The first argument and third arguments were considered waived, as she had failed to advance it before the Board. Therefore, the court did not address it on the merits.

The second was also rejected without full consideration on the merits. Because although the LOR cited immorality and the term came up at the hearing, the record as a whole made clear that the LOR was issued due to the criminal conviction.

Finally, the court determined that under the circumstances, the LOR, which was the most lenient form of discipline the Board could issue, was not inappropriate.

The court therefore affirmed.

Bottom Line: There were several interesting issues raised on appeal that, under Arkansas’s rather strict appellate rules, were not fully considered. They might well be useful to the next nurse facing disciplinary charges. However, ultimately, the case makes clear the limited scope of review of appeals under the Administrative Procedure Act, the need for licensed professionals to be careful about both their behavior and how they handle legal proceedings (especially criminal cases) stemming therefrom, and that in agency proceedings, parties often need to marshal as many arguments as possible at the earliest possible moment to ensure they are preserved for further review.

Nurses, physicians, and other licensed professionals facing revocation, suspension, reprimand, or other discipline by an Arkansas administrative agency should not hesitate to contact our firm for assistance.