Michael Ryan Downs was arrested in January after he allegedly attacked 26-year-old Daniel Ridgeway with a kitchen knife.
Downs had used methamphetamine and stopped taking his bipolar disorder medication before the stabbing, prosecutors say. The suspect's parents told he was acting erratically and had become convinced that Ridgeway - who had recently come to live with Downs and his parents after losing his home - was a sexual predator bent on attacking Downs' mother and sister.
Ridgeway had to be hospitalized after the attack, where he developed complications from his injuries including staph and fungal infections, gangrene in his gallbladder and blood clots. He died on March 26, and his death has been ruled a homicide.
Downs entered not guilty pleas to first-degree murder and possession of drugs and paraphernalia. He is set for a review hearing in August, and a trial is scheduled for Jan. 23, 2017.
If found guilty, Downs could face up to life in prison or the death penalty.