My sister and I are giving 24/7 care for my mother who is unable to care for herself. My sister has decided to pay herself for this care. She is retired as am I so we are not losing wages. Is it legal for POA to receive payment for these services since it is not spelled out in the POA paperwork? She also wants to be paid “under the table" which bothers me. If I allow this could I get into a mess to allow this? We live in Missouri.

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Paying under the table would be a disaster. It would come under the heading of gifting, and your sister, whose future is as uncertain as any of our futures, may need care and medicaid support in the future. The lookback would show missing sums of money that could not be accounted for in the sister's costs of living. So that is OUT for certain.
When you are speaking of POA do you mean financial or health. If a POA pays himself or herself, or other close family, it is going to be questioned. It makes it less likely you can be approved as a paid caregiver.
I would caution you to get the advice of a GOOD elder care attorney now. Do not take the word of differing opinions on any Forum, no matter how good. A care contract would have to be solid and bullet proof and there would have to be meticulous record keeping and reporting to the IRS. Your Sister's account can pay for this Lawyer visit as it is in her interest to have her care directed correctly. Good luck, and you would contribute to the Forum if you tell us what you found out.
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According to Family Caregiver Alliance (FCA) website:

there is a "Consumer Directed State Plan Personal Care Program" via Medicaid (MO HealthNet) in Missouri that allows certain family members, excluding spouses and legal guardians, to be hired and paid to provide personal care services.
You can contact them at:
Missouri Department of Social Services Family Support Division:
Phone: 855-373-4636

Caregiver Eligibility: Anyone (excluding spouses)

Care Recipient Eligibility: 
-Must be a resident of Missouri
-Must be 18+
-Must be physically disabled
-Must require nursing facility level of care
-Must be able to self-direct their own care
-Must be Medicaid eligible

I agree that the best thing to do is to talk to an elder care attorney and have a "Caregiver Contract" completed and signed to insure that your family is following the law in Missouri in regards to family paid caregivers and that your family does not end up being accused of "financial elder abuse" or "Medicaid fraud" just because your sister wants to be "paid under the table".
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Family caregivers wanting to be paid should have a caregiver contract. POA doesn’t give the right to take money. This would not smell good in any legal sense
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The problem lies with being paid as POA and the POA not addressing payments. Check with your state's attorney general website and find out if your state requires the payment for POA services must be stated in the POA. My state requires that the POA address pay or you don't get paid.

Caregiving is not POA responsibilities. It is an entirely different thing and you both should be getting paid with a caregiver contract in place.

What your sister is doing could be misconstrued as financial exploitation of a vulnerable senior. It needs to be done legally to avoid this potential problem. As a POA she is a fiduciary, look it up, it it a serious business and the courts hold you to a higher level because of holding that position. She is endangering herself and your mom in the event that she ever needs public assistance.

Please, your sister and you need to see a certified elder law attorney ( and get caregiver contracts in place, hire a payroll agency to do the payroll above board and legal, it will cost mom more but, it protects everyone involved. Caregiving is really difficult and you both should be paid for what you do if your mom has the means to do so.

I hope that your sister is willing to do this all proper and legal. I personally would never want to stand in front of a judge and try to explain as a POA for someone what all that cash was about. I don't think I would do well in prison, especially for crimes against a senior. I understand that it makes your time difficult.
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