Skilled nurses would be permitted to continue serving at-home patients under a bipartisan bill offered Dec. 10 by U.S. Rep. Mike Rulli (R-OH) that would develop national quality standards for continuous skilled nursing services provided through Medicaid.
“Right now, federal regulations written for a different era are preventing families from accessing specialized, in-home nursing and pushing providers out of the program,” Rep. Rulli said on Monday. “This bipartisan legislation makes sure the law no longer stands in the way of life-saving services and recognizes the unique, one-on-one work nurses do to help patients thrive at home.”
The Continuous Skilled Nursing (CSN) Quality Improvement Act of 2025, H.R. 6592, which Rep. Rulli sponsored alongside lead original cosponsor U.S. Rep. Greg Stanton (D-AZ), is companion legislation to the identical S. 1920 introduced on May 22 by U.S. Sens. Thom Tillis (R-NC) and Maggie Hassan (D-NH).
Together, the measures are aimed at simplifying federal rules so that continuous skilled nursing services can keep pace with how modern care is delivered: one-on-one, highly specialized support in the home for children and adults with complex medical needs, according to a bill summary provided by Rep. Rulli’s staff.
“The care provided by continuous skilled nursing is what allows many Ohioans with disabilities and complex medical conditions to remain at home while getting the care they need,” said Rep. Rulli, noting such services provide intensive, around-the-clock care in the home for patients who rely on ventilators, feeding tubes, seizure management, and other supports.
Families and providers report that a patchwork of outdated and overlapping federal requirements can delay services, discourage provider participation, and contribute to workforce challenges in a field already under strain.
The bill would streamline the requirements, clarify expectations, and remove unnecessary administrative barriers so that more patients can access care at home, says the summary.
“Too often providers run into a maze of outdated rules that simply don’t fit the care being delivered today,” said Rep. Stanton. “Our bipartisan legislation will advance patient care and remove provider red tape, and I look forward to working with Congressman Rulli to pass it into law.”