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.