Continuous Skilled Nursing Quality Improvement Act of 2025
Sponsors
Legislative Progress
In CommitteeMr. Rulli (for himself, Mr. Stanton, and Mr. Pappas) introduced …
Summary
What This Bill Does
This bill improves the quality of continuous skilled nursing care for Medicaid patients who need multiple hours of nursing per day, such as medically fragile children. It renames "private duty nursing services" to "continuous skilled nursing services" and requires these services to be provided by licensed nurses (RNs or LPNs), while also establishing national quality standards.
Who Benefits and How
Medicaid beneficiaries requiring continuous nursing care (especially complex-care patients like medically fragile children) benefit from guaranteed care by licensed nurses and improved quality standards.
Licensed nurses (RNs and LPNs) benefit from expanded job opportunities as the bill requires skilled nursing services to be provided by licensed professionals.
Private duty nursing agencies benefit from exemption from Medicare home health agency participation requirements, reducing their regulatory burden.
Who Bears the Burden and How
The Secretary of Health and Human Services must undertake extensive rulemaking, convene stakeholder working groups, develop quality standards, and periodically update quality measures.
State Medicaid programs must implement new national quality standards and update their HCBS quality measures.
Managed care entities contracting with Medicaid will face new compliance requirements around quality standards.
Unlicensed care providers and aides face increased barriers to providing these services as the bill requires licensed nurses for complex-care patients.
Key Provisions
- Renames "private duty nursing services" to "continuous skilled nursing services" in federal law, effective 18 months after enactment
- Requires continuous nursing services for complex-care patients to be provided by licensed nurses (RNs or LPNs)
- Mandates HHS to convene a stakeholder working group within 180 days to develop national quality standards
- Exempts private duty nursing providers from Medicare home health agency participation requirements
- Adds continuous skilled nursing to the list of home and community-based waiver services (HCBS)
- Requires periodic update of quality measures at least every 8 years
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Establishes national quality standards for continuous skilled nursing services provided through Medicaid and renames 'private duty nursing services' to 'continuous skilled nursing services' to better reflect the nature of care provided.
Policy Domains
Legislative Strategy
"Improve quality of care for Medicaid beneficiaries requiring continuous skilled nursing by establishing national standards and clarifying service definitions."
Likely Beneficiaries
- Medicaid beneficiaries requiring continuous skilled nursing care
- Complex-care patients (especially children) who need multiple hours of nursing per day
- Private duty nursing agencies and providers
- Licensed nurses (RNs and LPNs) providing continuous care
Likely Burden Bearers
- Secretary of Health and Human Services (rulemaking requirements)
- State Medicaid programs (implementation of new standards)
- Managed care entities contracting with Medicaid programs
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
An individual entitled to or enrolled for benefits under Medicare Part A or Part B, and eligible for full Medicaid benefits under section 1902(a)(10)(A) or 1902(a)(10)(C) of the Social Security Act.
An individual who is eligible for, and enrolled in, a State Medicaid program.
The State program under title XIX of the Social Security Act, including any waiver or demonstration under such title.
Has the meaning given in section 1905(a)(8) of the Social Security Act as in effect on the date of enactment.
The Secretary of Health and Human Services.
Has the meaning given in section 1101(a) of the Social Security Act for purposes of title XIX.
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology