This manual, developed for the nursing home employee, examines the concept of quality assurance in nursing homes, describes the benefits of an effective quality assurance program, and provides guidelines to aid nursing homes in developing an appropriate quality assurance program. After a brief introduction, a working definition of quality assurance is provided, and the four steps in the quality assurance cycle are delineated: identifying needs, planning, implementing changes, and evaluation of results. The next chapter discuss the quality of life mission of nursing homes; this is followed by guidelines for administrators and supervisors in dealing with staff. The next three chapters provide specific suggestions for quality assurance in various aspects of nursing home management: building a positive community image, addressing the needs of families, and improving the nursing home environment. Costs of quality assurance are next considered, and two types of quality assurance program--informal and formal--are described and compared. The manual concludes with guidelines for developing such a program, and sample documentation is appended, along with a list of references. (TE)