Sens. Tillis, Hassan Introduce Continuous Skilled Nursing Quality Improvement Act to Strengthen Medicaid Nursing

Legislation was developed with input from Home Care Association of America (HCAOA) and the National Alliance for Care at Home (Alliance).

WASHINGTON, DC, UNITED STATES, June 20, 2025 /EINPresswire.com/ -- Senator Thom Tillis (R-NC) and Senator Maggie Hassan (D-NH) introduced Senate Bill 1920, the Continuous Skilled Nursing Quality Improvement Act of 2025, a critical piece of legislation aimed at improving the quality and accessibility of skilled nursing care under Medicaid. This bill will modernize Medicaid’s approach to private duty nursing, ensuring that participants with complex medical needs receive consistent, high-quality care in their homes.

"Patients and families who rely on in-home skilled nursing are being left behind due to outdated regulations and inconsistent standards,” said Senator Tillis. “I’m proud to introduce this bipartisan legislation to modernize support for those with serious medical needs by removing red tape and creating consistent guidelines that will improve quality of care.”

The legislation was developed with input from the Home Care Association of America (HCAOA) and the National Alliance for Care at Home (Alliance), both of which have strongly endorsed the bill as an essential step toward strengthening Medicaid’s skilled nursing services.

“This bill is a game-changer for Medicaid patients who rely on skilled nursing at home,” said Jason Lee, CEO of HCAOA. “By modernizing outdated regulations and setting national quality standards, we can ensure that patients receive the care they need, when and where they need it. Our members are grateful for Senator Tillis (R-OH), Senator Sullivan (R-AK), Senator Hassan (D-NH), and Senator Cortez Masto’s (D-NV) bipartisan leadership on this issue.”

Founded in 2002, HCAOA is one of the home care community’s leading trade associations—currently representing over 4,500 companies that employ countless caregivers across the United States. Our member agencies provide medical, skilled, personal and companion home care, enabling seniors and individuals with disabilities to remain in their homes as long as possible at a cost that is more affordable than institutionalized care. Home care also encompasses Private Duty Nursing (PDN), which is medically necessary nursing services under Medicaid caring for medically fragile patients, primarily children. Our members and their caregivers assist with a variety of non-medical activities of daily living, such as bathing, dressing, eating, and other services necessary for seniors and the disabled to thrive at home.

“We are excited to support the Continuous Skilled Nursing Quality Improvement Act and want to thank Senators Tillis, Sullivan, Hassan, and Cortez Masto for their leadership on this legislation. This bill will make important updates to the continuous skilled nursing services program, including improving quality measurement, clarifying provider participation requirements, and updating the benefit to reflect modern service delivery. These improvements will increase access to services and improve the quality of care provided to individuals in Medicaid.”

The National Alliance for Care at Home is the unified voice for providers delivering high-quality, person-centered healthcare to individuals, wherever they call home. Our members are providers of different sizes and types, from small rural agencies to large national companies, including government-based providers, nonprofit organizations, systems-based entities, and public corporations. Our members serve over 4 million patients nationwide through a dedicated workforce of over 1 million employees, staff, and volunteers. Formed through the joint affiliation of the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO), the Alliance is dedicated to advancing policies that support care in the home for millions of Americans at all stages of life, individuals with disabilities, persons with both chronic and serious illnesses as well as dying Americans who depend on those supports.

The Continuous Skilled Nursing Quality Improvement Act of 2025 directs the Department of Health and Human Services (HHS) to work with stakeholders, including providers, patient advocacy groups, and state Medicaid agencies, to develop national quality standards. These standards will improve oversight
and ensure that Medicaid patients receive high-quality care from licensed nurses.

Key Provisions of the Bill:
-Terminology Modernization: Updates the definition of private duty nursing to “continuous skilled nursing services” to reflect the needs of patients requiring extended skilled nursing care.
- National Quality Standards: Requires HHS to convene a working group to develop national standards for continuous skilled nursing services.
- Medicaid Coverage Clarity: Ensures Medicaid providers are not subject to Medicare home health agency participation conditions, reducing regulatory burdens and improving access to care.
- Home and Community-Based Services Inclusion: Expands Medicaid’s home and community-based services (HCBS) waiver program to include continuous skilled nursing care.
- Quality Measure Updates: Directs HHS to update and maintain quality measures for Medicaid-covered skilled nursing services.

Eric Reinarman
Home Care Association of America
+1 (305) 542-5749
eric@hcaoa.org