Will Medicaid make me pay that back?

I am also her Power of Attorney on all matters.

Yes, they will. They will refuse to pay.

I had a typo, I meant to say she basically paid me the money to take care of her

And of course you declared that as wages on your tax return? Otherwise it is a gift, and gifts become penalties when you apply for Medicaid.

The 20 large that mom gave you will likely be viewed as a transfer penalty by Medicaid. If all the 20 comes up on radar will depend on whether the state does a full 5 year look back or less time. Each state manages Medicaid in their own unique way. For us, the lookback was 3 years & 6 months, I've know of those whose lookback was just 6 months, other the full 5 years. But whatever the case, transfer penalties due to "gifting" are totally sticky to deal with or get around too. I think you are best going to see an elder law attorney to see if there are any options at this late point in time to deal with this.

Transfer penalties are set for a period of time formula based on a what your state has set as it's daily reimbursement rate for Medicaid room & board. Lets say mom is in TX and TX daily R&B is $ 145.00 (which is pitiful low too). Now mom gave you $ 25K, it will be viewed as a gift (If you didn't have a personal care agreement or contract in place and didn't have mom do a W-9 to you, etc., then it probably will be viewed as gifting) The 25K means that for 172 days mom - although now qualified for Medicaid as she is impoverished - will be ineligible for Medicaid to pay for the stay @ the NH. (25K divided by 145 = 172). If your state's reimbursement is higher, say $ 380, then penalty period would only be 65 days. Understand?

Now transfer penalties for $$ gifting seem to be set on period of time rather than repayment. They kinda expect you to private pay for whatever the # of days of ineligibility. Now if mom gifted her home to you, those seem to be OK just to be "sold back" or transferred back to the elder to be OK almost as if it didn't happen and then can qualify (although usually the family puts the house for sale)

Transfer penalties are also sticky in that the NH will get the penalty letter too. So they know that mom is Medicaid ineligible for X # of days. THe NH will fully expect you to come up with payment or sign off on a contract in order for mom to continue to stay @ the NH. If mom went into the NH under "Medicaid Pending" and gets disqualified from Medicaid, it can be a total panic situation for family. If you know this is coming, I'd suggest you go and speak with the billing office as to what is possible. You mom has monthly income (her SS & retirement) so the NH will be getting that income, so can you pay the difference for the penalty period?

I fervently wish that parents would pay their children who take care of them! Medicaid does not expect elderly or infirm people to not have care expenses. If there is a written personal care agreement in place, spelling out what the parent is paying and what the child is doing for that money, there will not be questions of "gifting" or of favoring one child over another, etc. It is what it is. Why try to hide it?

But that is my rant for people who are earlier in the process than you are. For you, I agree that you should see an Elder Law attorney and see what can be salvaged at this point. And I sincerely wish you well. You and Mom both were just trying to do the loving thing.