This bill changes how Medicaid pays for and oversees nursing care that people receive at home or in community settings. Right now, this type of care is called "private duty nursing services," but the bill renames it "continuous skilled nursing services" to better reflect what it actually is.

The main goal is to improve the quality of this care by creating national standards that all states must follow. The bill requires the federal government to bring together nursing providers, patient advocates, state officials, and other experts to develop these quality standards within six months. Once created, states will need to use these standards when they pay for nursing services. The bill also requires that patients who need more than two hours of nursing care per day must receive care from a licensed nurse—either a registered nurse or licensed practical nurse—for the government to pay for it.

This affects people on Medicaid who receive skilled nursing care at home, particularly those who are elderly or have complex medical needs. It also impacts the nursing agencies that provide these services and the states that run Medicaid programs. The changes take effect gradually over 18 months, giving states and providers time to adjust. Additionally, the bill clarifies that private duty nursing agencies don't have to follow the same rules as home health agencies, which should reduce their paperwork burden.