HCAOA Launches Campaign on Continuous Skilled Nursing Bill

Families caring for medically fragile children and adults rely on continuous skilled nursing services to keep their loved ones safe at home. Yet Medicaid’s policies governing these essential services haven’t kept pace with the changing needs of patients, caregivers, or providers. Outdated language, inconsistent regulatory expectations, and unclear quality standards have created barriers that directly impact access to care

That’s why HCAOA, along with a broad coalition of national stakeholders, strongly supports the Continuous Skilled Nursing Quality Improvement Act of 2025 (H.R. 6592 / S. 1920). This bipartisan legislation modernizes Medicaid’s approach to continuous skilled nursing and provides long-overdue clarity and support for families and care providers.

Why this legislation matters

For too long, Medicaid’s “private duty nursing” benefit has lacked the structure and consistency needed to serve today’s medically complex population:

• Families struggle to secure adequate nursing hours.
• Providers must navigate conflicting regulations and outdated terminology.
• Workforce challenges persist due to policy ambiguity and inconsistent oversight.

The Continuous Skilled Nursing Quality Improvement Act directly addresses these issues by establishing clear national standards and updating the HCBS framework to reflect modern care models.

What the bill would do

If enacted, the legislation would:

• Modernize terminology by replacing “private duty nursing” with “continuous skilled nursing services.”
• Create national quality standards through an HHS-led stakeholder working group.
• Reduce regulatory burden by clarifying that Medicaid providers are not subject to Medicare home health participation requirements.
• Strengthen HCBS options by ensuring continuous skilled nursing services are explicitly included in waiver programs.
• Update Medicaid quality measures related to skilled nursing.

These improvements would increase transparency, support workforce stability, and ensure that medically fragile children and adults can receive consistent, high-quality care in their homes and communities.

How you can help
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While momentum is building in Congress, your voice is essential to move this bill forward. We encourage all HCAOA members to contact your members of Congress through our Voter Voice campaign.
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For questions about the legislation or the advocacy campaign, please contact HCAOA Vice President of Government Relations, Eric Reinarman, at [email protected].