Building the Nation’s

Most Competent

Direct Service Workforce

One Caregiver At A Time

Looking to complete The QuILTSS

Institute Orientation Course?

What is QuILTSS?


Quality  Improvement in Long  Term  Services and  Supports or  QuILTSS is a value-based purchasing initiative, led by the Bureau of TennCare, to promote the delivery of high quality Long Term Services and Supports (LTSS), focusing on the performance measures that are most important to people who receive LTSS and their families. This initiative rewards providers that improve the member’s experience of care and promote a person centered care delivery model. The  QuILTSS initiative includes outcome based reimbursement for services such as Nursing Facility Care, Enhanced Respiratory Care, Home and Community Based Services, Behavioral Health Crisis Prevention Intervention and Stabilization Services (SOS). Additionally, QuILTSS has programs dedicated to the development of the LTSS workforce.

Looking to complete

The QuILTSS Institute Orientation Course?

The QuILTSS Institute’s mission is to build a more competent workforce, leading to an increase in the quality of care and quality of life for those receiving long-term services and supports.


To achieve its mission, The QuILTSS Institute offers a wide-range of services, including:

Competency-Based Programs

Designs and implements high-quality, college-credit worthy competency-based training programs, offered online through a robust learning management system.

Research & Best Practices

Conducts and publishes research on QuILTSS outcomes and best practices in order to improve long-term services and supports.

Customized Development

Provides customized training services, upon request, to providers, states and other organizations interested in improving LTSS.

Virtual Simulation Assessments

Oversees a virtual assessment center where direct care professionals demonstrate competence before earning LTSS credentials.

Higher Education Liaison

Coordinates and partners with state agencies, community colleges and four-year institutions to offer workforce development curriculum for credit.

Professional Services

Offers wide-range of professional services to providers, state agencies and other organizations designed to enhance workforce competencies.

Credential Registry

Manages credential registry, including making credential recipient information available to states for value based purchasing efforts.

Program Oversight

Maintains the rigor and relevance of QuILTSS training by continually assessing, adjusting, adding, and enhancing training offerings to meet emerging workforce challenges.

Meet our Team

Melissa Walker

Managing Director of Operations

Melissa leads the daily operations for The QuILTSS Institutions and drives forward all operational elements for The Institute, including the QuILTSS Workforce Development program. These duties include monitoring workflows and making timeline adjustments to achieve project milestones; implementing and maintaining developmental best practices; and working with multiple interdisciplinary teams to achieve stated objectives. Melissa collaborates with both internal and external partners including subject matter experts, the online learning platform team, assessment designers, instructional designers, and providers/MCOs in the field of long-term care. In addition, Melissa serves as the main liaison between The QuILTSS Institute and its institutional partners. Her background is in finance, economic, and accounting, having taught for the past 18 years at various community colleges and universities. Prior to that, she worked at GE Capital, the financial arm of General Electric, for seven years in various capacities including marketing, accounting, and project management. Melissa holds a Masters of Arts in Economics from Middle Tennessee State University, a Masters of Business Administration with an emphasis in Entrepreneurship from the University of Colorado-Denver, and a Bachelor of Science in Accounting from Elon University with a minor in Mathematics. She is currently working toward her PMP Certification.

Tiffany Denton

Chief Assessment Officer

Tiffany focuses on the design of behaviorally-based assessments andcurriculum for competency-based education programs.  Within this role, Tiffany facilitates the build of curriculum using the backward design process to promote learner performance change on the job. This curriculum design process includes with a curriculum team including subject matter experts (SME), curriculum designers, assessment designers, and instructional designers to create an engaging and competency-based learning experience. Specifically, Tiffany focuses her work on the design of behaviorally-based assessment exercises that require each learner to demonstrate knowledge, skills, abilities, and intellectual behaviors to validate learner competence across a pre-determined and defined set of competency areas. She manages a team of virtual assessors and consultant SMEs.  Prior to her current role, Tiffany served as Assistant Dean in the College of Professional Studies at Lipscomb University where she led the Curriculum and Academic Team to the launch of PACE, Lipscomb’s 126-credit hour competency-based program. She also served as an assistant professor, administrator of Lipscomb’s behaviorally-based CORE Assessment Center, as well as engaged multiple employer partnerships. Tiffany spent six years studying at The University of Memphis earning the Master of Arts and Education Specialist degrees in School Psychology, as well as the Doctor of Education degree in Applied Behavior Analysis. She is recognized as a Nationally Certified School Psychologist and a Board Certified Behavior Analyst with doctoral designation.

Board of Directors

Charla Long, Board Chair

Long is President of Go Long Consulting, a firm focused on aging services and higher education innovation, and the Executive Director for the Competency-Based Education Network, a national consortium of higher education institutions and statewide systems seeking to design, develop, and scale new models of student learning. Long was the founding dean of the College of Professional Studies at Lipscomb University and the creator of their nationally acclaimed competency-based education (CBE) model and badging ecosystem. She has over 20 years of experience in the higher education setting. 


Before leaving Lipscomb, Long served on the University’s Academic Leadership Team, setting the academic vision for the entire University, and built, developed, and inspired a team of individuals to achieve college objectives. Long, as Creator and Founder of The School of TransformAging®, was selected by Tennessee Governor Bill Haslam to chair the Governor’s Task Force on Aging. As Chair, Long authored the Governor’s strategic plan, drawing from the public, private, and nonprofit sectors, to better meet the needs of older Tennesseans and their families. 


She has extensively supported Tennessee’s Bureau of TennCare on multiple stakeholder engagement and technical assistance projects, including on the Quality Improvement in Long Term Services and Supports (QuILTSS) value-based purchasing initiative. On the QuILTSS project, Long facilitated nearly two dozen stakeholder engagement sessions, planned and led all meetings between the State and key stakeholders, oversaw the research and production of Robert Wood Johnson Foundation funded technical assistance report, and assisted in the development of the State’s pay-for-performance quality framework. Additionally, Long oversaw the multi-year project to design the QuILTSS workforce development offerings. 


Over the years, Long has worked with multiple nursing facilities on Directed Plans of Correction and coordinated compliance efforts with CMS. Long has trained thousands of direct service professionals in countless facilities throughout the southeast United States.

Keith Payet, Board Secretary & Director

Keith C. Payet is the Chief Executive Officer for UnitedHealthcare Community Plan of Tennessee. Keith has over 15years’ of experience in the Healthcare Managed Care industry specializing in programs for the underserved and underprivileged. He has held many leadership roles in Government Programs, Operations and Compliance.  He beganhis healthcare career as a Lead SIU Investigator for the Capital District Physician’s Health Plan of Albany, New York.He was the Chief Compliance Officer for HHH Choices a Long Term Care, an LTSS, Medicare Advantage and Fully Integrated Dual Eligible (FIDE) plan. He also, served as the Chief Operating Officer for Integra a Managed Careorganization with leadership responsibility for both the Long Term Care and FIDE programs. Most recently, Keith served as the Executive Director of the CHOICES Long Term Services and Supports program.  Keith holds a Bachelor’s Degree in Criminal Justice with a minor in Political Science from Plattsburgh State University and aGraduate Certificate in Not-for-Profit Management from The College of St. Rose.

Rebecca Kelly, Board Member

 Rebecca B. Kelly has served as State Director for AARP Tennessee since 2005. In this role, Rebecca oversees the work of a team of eight staff and more than 1,000 volunteers, who are among the state’s 640,000-plus members. Rebecca has spoken consistently and passionately on issues of interest to people over 50 and their families and has served on numerous regional and national working groups with AARP. Most recently, she served on Tennessee Governor Bill Haslam’s Task Force on Aging. Prior to serving as State Director, Rebecca worked for nine years as Associate State Director, focusing on volunteer management and community organizing. Before moving to Nashville in 1996, Rebecca served as AARP’s Southeast Regional Economic Security Representative for 14 states, managed Senior Employment Programs for Louisiana’s State Unit on Aging, was a Teaching Associate at Louisiana State University and, just prior to joining AARP, served as a consultant to older worker programs for the Georgia Department of Labor. Rebecca has more than 30 years of experience in the field of aging. She holds a Master’s Degree in Public Administration from Georgia State University