# 119-hr-6592: Continuous Skilled Nursing Quality Improvement Act of 2025

119-hr-6592, Continuous Skilled Nursing Quality Improvement Act of 2025, is a 119th Congress bill sponsored by Rep. Rulli, Michael A. [R-OH-6] (R-OH); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-6592
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-6592
- Congress: 119
- Title: Continuous Skilled Nursing Quality Improvement Act of 2025
- Status: introduced
- Introduced: 2025-12-10
- Sponsor: Rep. Rulli, Michael A. [R-OH-6] (R-OH)
- Cosponsors: 4
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**National quality standards for continuous skilled nursing under Medicaid.** This bill would redefine private duty nursing as continuous skilled nursing and set national clinical and licensing expectations for that care within Medicaid and Home and Community-Based Services (HCBS). - Families and Medicaid beneficiaries: Complex-care patients would have a clarified pathway to licensed continuous skilled nursing led by registered or licensed practical nurses, with the new definition taking effect about 18 months after enactment. - Providers and States: The Secretary would convene a stakeholder working group within 180 days to draft standards, and would tell State Medicaid Directors that these providers are not subject to Medicare home health agency participation rules. - Measurement and program updates: States, managed care plans, and providers would use national standards published after public notice and comment, with HCBS waiver services updated within 18 months and the HCBS quality measure set updated within 1 year and reviewed at least every 8 years.

## Cosponsors (4)

- Rep. Stanton, Greg [D-AZ-4] (D-AZ), 2025-12-10T00:00:00.000Z
- Rep. Pappas, Chris [D-NH-1] (D-NH), 2025-12-10T00:00:00.000Z
- Rep. Gottheimer, Josh [D-NJ-5] (D-NJ), 2026-01-07T00:00:00.000Z
- Rep. Taylor, David J. [R-OH-2] (R-OH), 2026-02-03T00:00:00.000Z

## Provisions PRIA read

- Medicaid moves to continuous skilled nursing: benefit, medium. If enacted, Medicaid would replace “private duty nursing” with “continuous skilled nursing.” The change would take effect 18 months after enactment. HHS would update federal rules by that time and add continuous skilled nursing to home- and community-based waiver services. The bill would also defin…
- National standards for Medicaid home nursing: benefit, medium. If enacted, HHS would convene a group of states, providers, patients, and advocates within 180 days. Within one year after the first meeting, the Secretary would publish national quality standards after public comment. States, managed care plans, and providers would use them for continuous skilled…
- Medicaid nursing not bound by Medicare rules: benefit, low. If enacted, HHS would send a letter to State Medicaid Directors. It would state that Medicaid private duty/continuous skilled nursing providers do not have to follow Medicare home health agency participation rules. This clarifies compliance for states and providers and does not change household pay…
- Licensed nurses for complex-care patients: mixed, medium. If enacted, HHS would set a rule within 18 months for certain patients. If your State decides you need multiple hours of continuous nursing each day, your care would have to be delivered by a licensed nurse (RN or LPN). This could improve safety but might make staffing harder in some areas.

## Related bills

- 119-hr-8870: BUILD America 250 Act
- 119-hr-3151: SHIPS for America Act of 2025
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-2853: Combating Organized Retail Crime Act of 2025
- 119-hr-1422: Enhanced Iran Sanctions Act of 2025
- 119-hr-9250: Great American Outdoors Act 250

## Sources
- [119-hr-6592 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/6592)

## Related
- [119-hr-8870: BUILD America 250 Act](https://policyrisk.com/legislation/119-hr-8870)
- [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-2853: Combating Organized Retail Crime Act of 2025](https://policyrisk.com/legislation/119-hr-2853)
- [119-hr-1422: Enhanced Iran Sanctions Act of 2025](https://policyrisk.com/legislation/119-hr-1422)
- [119-hr-9250: Great American Outdoors Act 250](https://policyrisk.com/legislation/119-hr-9250)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-6592 (as of 2026-04-21).