|Bureau of Long Term Care
|Ann Ricks, RN, MSN
| Bureau Director
EXECUTIVE SUMMARY - Comprehensive Review of Long Term Care Services
The Bureau of Long Term Care provides services for Medicaid beneficiaries through
its Home and Community Based Services (HCBS) waiver programs and the Hospice program;
and in the institutional setting for nursing homes, intermediate care facilities,
and those in the institutional setting that elect Hospice
services. It is the mission of the Division of Medicaid to provide the most appropriate
services to its beneficiaries as funding allows.
The Divisions in the Bureau of Long Term Care are:
Click here to download LTC Staff Responsibilities
Civil Money Penalty (CMP) Grant Awards Program
The goal of the Mississippi Division of Medicaid Civil Money Penalty Grant program
is to facilitate the use of Federally Imposed Civil Money Penalty Funds to support
activities that support, protect and benefit residents living in nursing facilities.
Only CMP fund applications that meet the statutory intent of the regulations, Federal
law and policy will be considered. The CMP Grant program will accept applications
from certified nursing facilities, academic or research institutions, state, local
or tribal agencies, profit or not-for-profit, or other types of organizations that
are interested in promoting quality of care and/or quality of life for residents
of nursing facilities which have been certified as meeting the requirements of participation
for Medicaid and Medicare by the Mississippi Department of Health, Bureau of Health
Facilities Licensure and Certification. Nursing home providers and stakeholders
are encouraged to submit CMP grant applications for the development and implementation
of quality improvement initiatives that directly or indirectly benefit nursing facility
residents. Enhancement or educational grants should demonstrate current and sound
evidence-based practices that promote quality of care and quality of life for nursing
CMP Grant Invitation
CMP Grant Proposal Requirements
CMP Grant Application
For more information: Phone 601-359-5191 or e-mail CMPGrants@medicaid.ms.gov
Division of Medicaid Long Term Care Transition to Community Referral (TCR)
As the Local Contact Agency (LCA) DOM has the responsibility of ensuring that individuals
in nursing facilities who express a desire to talk with someone about the possibility
of returning to the community are provided timely information about available options
and supports for community living and to support individual choice. Click
on the "TCR Form" link below to access and submit a referral. Instructions
for completing the TCR Form, information regarding the TCR Referral Process and
Resource Information can also be accessed below.
TCR Form Instructions
TCR Referral Process
TCR Flow Chart
TCR Resource Information
For more information: Phone 601-359-6141 or e-mail TCR@medicaid.ms.gov
Division of Medicaid Long Term Care Pre-Admission Screening
To enter a Long Term Care program (except Hospice and ICF/MR), an eligible Beneficiary must have a Pre-Admission Screening Application completed by a health care professional and certified by a physician. A score of 50 or above is required threshold to be considered for entry into the Long Term Care programs of Nursing Homes; Elderly and Disabled, IL and TBI/SCI; and Assisted Living Waiver program. Any exceptions are noted in the Administrative Code Title 23 Medicaid, Part 207 Chapter 1.
Pre-Admission Screening Long Term Care Application
Pre-Admission Screening Instruction Manual
Pre-Admission Screening Scoring Algorithm
Informed Choice Form
For more information contact: 601-359-6141
Nursing Homes and Case Mix
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
The Case Mix/Institutional Long Term Care Division
is responsible for monitoring the Licensure and Certification Branch of the State
Department of Health. Licensure and Certification (L&C) surveys nursing facilities
and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). DOM imposes
recommendations from L&C on nursing facilities and ICFs/IID that are out of compliance
with the federal regulations. The agency Division has the discretion of imposing
civil and monetary penalties and other remedies when recommended.
The Institutional Long Term Care Division is responsible for the development, monitoring
and enforcement of policy for nursing facilities and intermediate care facilities
for the mentally retarded approved by Medicaid and federal certification requirements
established by the Centers for Medicare and Medicaid.
Staff are also responsible for the Case Mix program which ensures accuracy of nursing
facility resident assessment data used to establish resident classification and
subsequent reimbursement payment rates for nursing facilities.
For Minimum Data Set (MDS) questions only, call the case mix help line at 601-359-5191
For Nursing Facility or ICF/MR questions, call 601-359-5191.
Please refer to the Administrative Code Title 23 Medicaid, Part 207 Chapter 2 Nursing Facility , and Part 207 Chapter 3 Intermediate Care Facility for Individuals with Intellectual Disabilities for additional information.
Hospice Benefit is a State Plan service for terminally ill individuals at the end
of their life cycle and having certification from a physician with a life expectancy
of six (6) months or less. Hospice provides palliative treatment such as nursing
care, medical social services, physician services, counseling short term patient
care, medical appliances and supplies, drugs related to terminal condition, home
health aide or homemaker, or non-restorative therapies.
For Mississippi Medicaid purposes, palliative is defined as the relief of severe
pain or other physical symptoms and supportive care to meet the special needs arising
from physical, psychological, spiritual social and economic stress which are experienced
during the final stages of illness and during dying and bereavement. Through this
emphasis on palliative rather than curative services, individuals have a choice
whenever conventional approaches for medical treatment may no longer be appropriate.
For more information call (601) 359-6141.
Bureau of Long Term Care
HCBS Waiver Programs
Elderly and Disabled Waiver
Assisted Living Waiver
Injury/Spinal Cord Injury
Assisted Living Waiver
The Assisted Living Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care provided in a nursing facility. This statewide waiver is administered by the Division of Medicaid. Qualified beneficiaries are allowed to reside in a Personal Care Home-Assisted Living (PCH-AL) facility that is licensed as a PCH-AL Facility by the Mississippi State Department of Health and is approved as a Medicaid provider for Assisted Living services. Medicaid reimburses for the services received in the facility.
Eligibility for the Assisted Living is limited to individuals twenty-one (21) years of age and up and who meet clinical eligibility requirements determined through screening the following areas: activities of daily living, instrumental activities of daily living, sensory deficits, cognitive deficits, client behaviors, medical conditions, and medical services. Beneficiaries of this waiver must be Medicaid eligible either as SSI recipient or meet the income level up to 300% of the SSI Federal benefit rate.
Services provided under the Assisted Living Waiver are case management, personal care, homemaker services, attendant care, medication oversight, medication administration, therapeutic social recreational programming, intermittent skilled nursing services, transportation and attendant call system.
This waiver sets aside five (5) waiver slots for participants with acquired traumatic
brain injuries who are in a family/participant crisis or have behavioral issues
that require twenty-four (24) hour supervision and assistance to successfully thrive
in a community or residential setting. If not for services provided in this waiver,
these individuals would require institutionalization. The object for offering this
service is to strengthen and support informal and formal services to meet the unique
needs, cognitively and behaviorally, for these waiver participants in a specialized
residential setting. Traumatic brain injury is defined as a traumatically acquired
non-degenerative structural brain damage. This term does not apply to brain injuries
that are congenital or due to injuries induced by birth trauma. There are specific
training requirements for this service provider.
Please refer to the HCBS Assisted Living Waiver for additional information.
Click here to download an Assisted Living Waiver Program Informational Pamphlet
Elderly and Disabled Waiver
The Elderly and Disabled Waiver program provides home and community-based services
to individuals 21 and over who, but for the provision of such services,
would require the level of care provided in a nursing facility. Beneficiaries
of this waiver must qualify for Medicaid as Supplemental Security Income (SSI) beneficiaries
or meet the income and resource eligibility requirements for income level up to
300% of the SSI Federal Benefit Rate and meet medical criteria of the program.
The Elderly and Disabled Waiver program is administered directly by the Home and
Community Based Services Division (HCBS). Case Management services are provided
by the Planning and Development Districts. The case management team is composed
of a registered nurse and a licensed social worker who are responsible for identifying,
screening and completing an assessment on individuals in need of at-home services.
Upon approval of the HCBS, the case managers can refer qualified individuals to
the following services: adult day health care, home-delivered meals, personal care services, institutional respite services, in-home respite, and expanded
home health visits.
Please refer to the
Home and Community-Based Services located on this Web site.
Click here to download an Elderly and Disabled Waiver Program
Independent Living Waiver
Independent Living Waiver
The Independent Living Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care found in a nursing facility. This statewide waiver is administered jointly by the Division of Medicaid and the Department of Rehabilitation Services.
Eligibility for the Independent Living Wavier is limited to individuals age sixteen (16) or older who have severe orthopedic and/or neurological impairments. Individuals must also be medically stable and be able to express ideas and wants either verbally or nonverbally with caregivers, personal care attendants, case managers, or others involved in their care. Beneficiaries of this waiver must be Medicaid eligible in one of the following Categories of Eligibility: SSI, Low Income Families and Children Program, Disabled Child Living at Home, Working Disabled, Children Under Age 19 Under 100% of Poverty, Disabled Adult Child, Protected Foster Care Adolescents, CWS Foster Children and Adoption Assistance Children, IV-E Foster Children and Adoption Assistance Children, or income level up to 300% of the SSI Federal Benefit Rate. Services provided under the IL waiver are case management, personal care attendant, environmental accessibility adaptations, specialized medical equipment and supplies, financial management services and transition assistance.
Services provided under the Independent Living Waiver are case management, personal care attendant, specialized medical equipment and supplies, transition assistance, and environmental accessibility adaptations and financial management services.
Please refer to the
Home and Community-Based Services located on this web site.
Click here to download an Independent LIving Waiver Program Informational Pamphlet
Traumatic Brain Injury/Spinal Cord Injury Waiver (TBI/SCI)
The TBI/SCI Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care found in a nursing facility. This statewide waiver is administered jointly by the Division of Medicaid and the Department of Rehabilitation Services.
Eligibility for the TBI/SCI Waiver is limited to individuals who have a traumatic brain injury or a spinal cord injury and are medically stable. The extent of the injury must be certified by the individual's physician. Brain or spinal cord injury that is due to a degenerative condition, congenital condition, or that resulted from medical intervention is excluded. Beneficiaries of this waiver must be Medicaid eligible in one of the following Categories of Eligibility: SSI, Low Income Families and Children Program, Disabled Child Living at Home, Working Disabled, Children Under Age 19 Under 100% of Poverty, Disabled Adult Child, Protected Foster Care Adolescents, CWS Foster Children and Adoption Assistance Children, IV-E Foster Children and Adoption Assistance Children, or income level up to 300% of the SSI Federal Benefit Rate.
Services provided under the TBI/SCI Waiver are case management, attendant care, respite, environmental accessibility adaptations, specialized medical equipment and supplies, and transition assistance.
Please refer to the HCBS Traumatic Brain Injury/Spinal Cord Injury
for additional information.
Click here to download a TBI/SCI Waiver Program Informational Pamphlet