MLTSS is designed, in DMAHS's own words, to expand home- and community-based services, using managed-care organizations to coordinate care wherever it's delivered — a person's home, assisted living, a community residential setting, or a nursing facility (New Jersey MLTSS overview).
The MLTSS application guide describes comprehensive care available in assisted-living facilities, group homes, nursing homes, or a person's own home, with a stated goal of letting people who need nursing-home-level care live wherever they choose while still getting the care they need. Facility residence isn't a prerequisite for applying (2026 MLTSS application guidance).
That said, the clinical bar doesn't move just because care happens at home — an adult still needs to show hands-on assistance with three or more activities of daily living, or cognitive deficits requiring supervision and cueing across three or more of them, to meet New Jersey's published standard (New Jersey MLTSS clinical criteria).
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