Is being a POA for my Mom enough instead of having a caretaker contract?

This is a question with a lot of aspects to it. Power of Attorney - Have you ONLY been spending "her" money on her own clothes, food, medicine, doctor visits, etc.? Do you keep "her" money in a separate bank account that you do NOT spend money on things for yourself or "shared" items? Power of attorney means that that expenditures of the elder's assets/income are only being used for the person you have POA for. If you are spending the assets of the elder on expenses that could be construed as for you only or shared by you, Medicaid will consider a part of that spending as gifts aka transfers. Caregiver contracts are a way of assigning a financial value to the services that you provide and expenses incurred to take care of a person. Medicaid lookback is 5 years. You will need to have very clear records of what you've spent in $$ and what for for the last 5 years if you think your mother will need to go into a nursing home using Medicaid. Honestly, you need to talk to an attorney with experience in Elder Care, Medicaid, and Medicare to see how the house is titled (certain ways can protect home from Medicaid Recovery, other ways do not) and how you've spent your money and your mother's over the last 5 years to make sure that you and your mother will not have problems when the time comes.