A system approach to quality assurance in long-term care facilities considers residents' total environment and all aspects of their livers--physical, social, psychological, spiritual, and intellectual. This approach lends a holistic perspective to quality assurance, expanding it from a "numbers game" to an integral part of the facility's philosophy. In developing measurement criteria for a quality assurance program, staff should not overlook systems, procedures, and reporting mechanisms already in place that may provide useful data. Some of these systems include risk management activities, continuing education programs, compliance reports, clinical affiliations, performance reviews, and peer review and administrative audits. Residents and their families are key sources of information about the quality of care. In addition to surveying these groups, long-term care facilities also should involve their resident councils in the quality assurance process.