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When I took my dad in, due to several health conditions that he was unable to care for alone and didn’t want to move to assisted living, I put together an estimate of costs. Things like cable (I stream), groceries, added expense of electric, water etc and then a modest amount of “rent” keeping it well below the cost of living in my area - a family deal so to speak. I’m now learning more and worry that I should have had a rental agreement in place for years prior otherwise, should the time for better care be a necessity, he could be penalized for “gifting” me rent. Can I backdate a rental agreement if he signs it? Do I need a notary or anything like that? I’m not trying to defraud the system just want to make sure him moving in with me and paying a very fair rent isn’t going to be perceived as a gift. To be fair I had to pay rent if I was going to stay at home as an adult and he would have never moved in without this. I should also mention he has a modest savings account that I have helped him invest and profit from but I don’t cover any of his bills as SS and retirement is enough that he has spending money and all needs taken care of. Should I still register as his caregiver?

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I would see an elder law attorney in your own State to tell you exactly what you can or cannot do at this point. It is to crucial to get it wrong. Your Dad's funds, if you are his POA can definitely pay for this.
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I'm thinking if the rental payments were at least a consistent amount, being paid at a consistent time of the month, this would help your case. I print out an itemized rent invoice for my mom every month, not just for her benefit but for anyone who needs to review it in the future. She pays by check because I'm joint on her checking account (just to help her do banking) but I don't use that account for anything myself. The "lookback" for Medicaid in my state is 5 years (60 months). Do you know what it is in yours? You can look it up online.
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No, you cannot backdate agreement. That looks even worse. Depending on the amounts, talk with Medicaid lawyer and get documented for past and set up agreement for future properly dated. And Medicaid might not catch the backdate, but if Medicaid is approved and then rejected and penalty assessed, it will be backdated to original date of admission. Not worth it.
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