The Continuous Skilled Nursing Quality Improvement Act of 2025 seeks to improve the quality of continuous skilled nursing services under the Medicaid program. It redefines "private duty nursing services" as "continuous skilled nursing services" within Title XIX of the Social Security Act and its implementing regulations. This change, effective 18 months after enactment, also mandates that these services for complex-care patients requiring multiple hours of continuous nursing be provided by licensed nurses , including registered nurses or licensed practical nurses. A key provision of the bill requires the Secretary of Health and Human Services to convene a working group within 180 days of enactment. This group, comprising various stakeholders such as providers, patient advocates, and State Medicaid officials, will develop national quality standards for continuous skilled nursing services. These standards, intended to improve the standard of care, will be published by the Secretary after a public notice and comment period. The bill also clarifies that providers of these services are not required to adhere to Medicare's home health agency conditions of participation. Furthermore, the legislation mandates updates to existing Medicaid regulations and quality measures. Within 18 months, the Secretary must revise the list of home and community-based waiver services to explicitly include continuous skilled nursing care services. Additionally, the bill requires an update to the Home and Community-Based Services (HCBS) Quality Measure Set within one year to incorporate core and supplemental quality measures specifically for continuous skilled nursing services, with subsequent reviews and updates every eight years.