Office	Address	Email
Division of Provider Services and Quality Assurance	700 Main Street Slot S-427 Little Rock, AR 72203-1437	[email protected]

Staff

Name	Title	Phone	Email
Martina Smith	Division Director	​501-396-6165	Email
Linda White	Deputy Director	501-396-6422	Email
Melissa West	Assistant Director for the Office of Long Term Care	501-353-8229	Email
Crystal Walton	Assistant Director for the Office of Community Services Licensure/Certification	501-251-6459	Email
Lee Honorable	Assistant Director for the Office of Performance and Engagement	501-320-6385	Email
Rebecca Dixon	Human Resources Manager	​501-320-6002	Email
Lasonja Evans	Chief Fiscal Officer, DPSQA	501-371-2959	Email
Rashad Campbell	Information Technology Manager	501-320-3919	Email

Incident and Accident Reports

Contact	ELS I&A Reporting
Incidents and Accidents	Provider Login

CNA Training & Certification

Name	Email	Phone
NATP Certification Unit	Email	501-682-2441, press 4 option

CNA Training Reimbursement (Facility-Based Programs)

Name	Email	Phone
NATP Certification Unit	Email	501-682-2441, press 4 option

Complaints (OLTC)

Name	Email	Phone
OLTC Complaint Hotline	Email	501-682-2441, press 2 option

Complaints (HCBS)

Name	Email	Phone
HCBS Complaint Hotline	Email	501-682-2441, press 6 option

Criminal Background Check

Name	Email	Phone
Long-Term Care Facilities, ADDT, CES Waiver	Email	501-682-2441, press 3 option
Placement & Residential- Child Welfare Agencies	Email	501-682-2441, press 3 option
Ebony Russ	Email	501-371-1351

Discharge Appeals (Long-Term Care Facilities)

Name	Email	Phone
Glenda Cooper	Email	501-320-3953

Employment Clearance Registry (Long-Term Care Facilities)

Name	Email	Phone
Ebony Russ	Email	501-371-1351

Enforcement (Home and Community Based Services) Nursing Facility Survey Review

Name	Email	Phone
Latasha Mays	Email	501-251-6459

Enforcement (Nursing Facilities – Federal) Nursing Facility Survey Review

Name	Email	Phone
Jeff Rosenbaum	Email	870-557-6122

Form 704 – Medical Needs Determination for Nursing Facility Placement/Waiver

Name	Email	Phone
Sandrae Nicholson	Email	501-320-6274
Med Needs Quickbase System	Email	501-682-2441, press 8 option
PASRR	Email	501-682-2441, press 8 option

Freedom of Information

Name	Email	Phone
Ebony Russ	Email	501-371-1351

ICF/IID Placement Determinations, Medical Needs Determination / PASRR, TEFRA

Email	Phone
DHS Medical Needs	501-682-2441, press 8 option

MDS/RAI, Staff Development (Office of Long Term Care)

Name	Email	Phone
Melissa West	Email	501-396-6186

MDS Upload

Name	Email	Phone
Keith Rogers	Email	501-683-0614
Vacant

Medicare/Medicaid Bed Certification, Nursing Facility & ICF / IID Licensure

Name	Email	Phone
OLTC Licensure Certification Unit	OLTC Licensure Certification	501-682-2441, press 1 option

Nursing Facility Administrator Program

Name	Email	Phone
Nursing Home Administrator Licensing Unit	Email	501-682-2441, press 4 option

Nursing Facility & ICF/IID DON Changes

Name	Email	Phone
OLTC Licensure Certification Unit	Email	501-682-2441