Home and Community Based Services Mississippi: Keeping Your Parent Out of a Nursing Home

Your parent just came home from the hospital. Medicare's home health coverage will last a few weeks, maybe a couple of months. After that, your parent still needs daily help — bathing, meals, medication reminders, someone to make sure they don't fall. A nursing home costs $8,500 to $9,000 per month in Mississippi. Home and community-based services (HCBS) through the state's Medicaid waiver can fund the alternative.

What Mississippi HCBS Covers

Mississippi's primary HCBS program for elderly adults is the Elderly and Disabled (E&D) Waiver, a 1915(c) Medicaid waiver that funds home-based services as an alternative to institutional placement. The services available through the waiver include:

• Personal care attendant — Assistance with bathing, dressing, grooming, toileting, and mobility. This is the core service most families need.
• Home-delivered meals — Daily meal delivery for homebound seniors who cannot cook safely
• Adult day health — Supervised daytime programs with nursing oversight, activities, and socialization. Provides structured care during work hours for families who can't leave their parent alone.
• Respite care — Temporary relief for the primary family caregiver, either in-home or at a facility
• Extended home health — Skilled nursing and therapy services beyond what Medicare covers
• Environmental modifications — Wheelchair ramps, grab bars, bathroom modifications, widened doorways — physical changes to make the home safe

These services are coordinated by a case management team assigned to your parent after approval. The case manager develops the care plan, arranges providers, and conducts periodic reassessments.

Who Qualifies

Eligibility has two parts: clinical and financial.

Clinical Eligibility

Your parent must need a nursing facility level of care (NFLOC), determined by the LTSS InterRAI assessment. The assessment is conducted in-person by a Registered Nurse and a licensed Social Worker through the Mississippi Access to Care (MAC) Center network. A score of 50 or higher on the LTSS instrument qualifies.

A physician certification is also required — your parent's primary care doctor must confirm the need for institutional-level care. This certification renews annually.

Financial Eligibility

The E&D Waiver uses the same financial criteria as institutional Medicaid:

• Gross monthly income under $2,982 (or diverted through a Qualified Income Trust)
• Countable assets under $4,000 for an individual
• Community Spouse Resource Allowance up to $162,660 if a spouse remains at home

The five-year look-back period applies — the Division of Medicaid reviews all financial transactions from the 60 months preceding the application for gifts, transfers, or asset movements that could indicate an attempt to qualify artificially.

The Application Process

1. Contact the MAC Center at 1-844-822-4622 to request a screening and schedule the LTSS assessment
2. Obtain the physician certification from your parent's primary care doctor
3. Complete the Medicaid application (Form DOM-ABDApp) and submit it to your parent's regional Division of Medicaid office with supporting financial documentation
4. Wait for both approvals — clinical eligibility through the LTSS assessment and financial eligibility through the Medicaid application (45-day statutory processing timeline)
5. If both are approved and a slot is available, a case management team is assigned and services begin

The Slot Limitation

The E&D Waiver is not an entitlement. Mississippi has approximately 22,200 federally authorized slots. When all slots are filled, eligible applicants are placed on a waitlist. The timeline depends on your parent's region and the current slot availability.

Families waiting for a slot should explore:

• Medicare home health — Free if your parent meets the homebound requirement and has a skilled care need
• Area Agency on Aging — Meals on Wheels, volunteer visitors, limited in-home services
• Private pay home care — $20–$28/hour in Mississippi for personal care assistance
• Transition assistance — If your parent is currently in a nursing facility and wants to return home, Mississippi reserves specific waiver slots for nursing facility-to-community transitions. Ask the case manager about this pathway.

HCBS vs. Nursing Home: The Decision

For many Mississippi families, the real question is not "home or nursing home" but "can we make home work?" HCBS services don't provide 24-hour coverage. A personal care attendant typically visits for a set number of hours per day based on the care plan. If your parent wanders at night, has severe dementia with safety concerns, or needs round-the-clock skilled nursing, institutional care may be necessary regardless of waiver availability.

The Mississippi Hospital-to-Home Transition Toolkit includes the E&D Waiver application roadmap, a Medicaid financial worksheet, and a home safety assessment checklist to help you determine whether home care is realistic for your parent's specific situation.

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