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They were in an independent living facility and didn’t like it, didn’t utilize the amenities they were paying for including meals. So we added on and moved them in. We now need to make adjustments to our home to better provide for them. Front porch step safety. Kitchen for meal planning. Non slip decking in backyard. Possible chair lift on stairway to their suite. Are these subject to look back when and if the time comes that we need assisted living or more care than we can provide? They have the means to make these changes. But I don’t want to jeopardize their future care. I want to keep them with us as long as possible but as we all know the future is unknown. I want to make things as comfortable for them that I can for as long as I can. But my house is not equipped for the needs that are arising. They will be here two years in April. This is their primary legal residence. I am caregiver with POA and MedPOA.

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Your parents can pay you for the housing, services and valuable geriatric care management you are providing now, without affecting their eligibility for Medicaid in the future, IF they comply with the eligibility regulations in your state.

Make it easy on yourself by talking with an Elder Law Attorney in your state who can show you how to make all the payments from your parents' funds conform to what a Medicaid case worker will expect to see when the time comes to apply for benefits.

If you invest the time and money needed now for Medicaid care planning, you won't be in panic mode if time runs out on your ability to provide at home care for one or both of your parents.

A written caregiver contract and rental agreement, documented with receipts for supplies and itemization of services you provide during the lookback period, are the foundation for a successful application.

You can't expect the Medicaid case worker to approve a retrospective agreement with disjointed records that are difficult to understand.
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Tchrlange, it's good that you're looking ahead so as to not jeopardize your parent's possible furture care. My advice is that you 1) discuss your situation with the Medicaid office in your state, and/or 2) talk to a good elder law attorney who is well-versed in Medicaid issues, and/or 3) implement a personal caregiver agreement (for which there is a discussion and template at www.agingcare.com).  I'm thinking that with a Medicaid-acceptable personal care agreement, you will at least be able to indirectly recover some or all of your expenses for home adaptations. Best wishes and kudos to you and your husband for taking care of your parents.
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When you say you want to "keep them with us as long as possible"...what will be the trigger for another form of care arrangement? And when you say your "house is not equipped for the needs that are arising", do you know that the quality of their care (and your care contribution) may be more about how much hands-on help they require? If they need help to get out of bed, use the bathroom, shower, cook, eat, take meds, be driven around, etc. Are you and your spouse up for being on-duty 24/7? There are many posts on this forum speaking to this issue, and it'd be wise for you to read some of them so that you know what you are signing up for.

In regards to the lookback issue, I would take your parents to an elder care attorney to know what your best legal course of action will be.
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