$14.28 of it is measured: what the rest of an hourly home care rate covers

One line item inside the rate has a published number. The others are real, and nobody publishes them.

By the rate desk. Written September 10, 2026.

An hourly home care rate is one number on an invoice. Underneath it are several costs the household never sees itemised. Exactly one of them has a federal statistic attached, and that is the caregiver's wage.

In the St. Louis metro the median is $14.28 an hour, and the bottom tenth of aides sit at $13.08. Payroll records for St. Louis County put the industry's average weekly wage at $763. Those are the floor. Nothing an agency charges can sit under them for long.

The one component with a published rate

Employer payroll tax is fixed by statute and published. On every dollar of wages an employer owes 6.2 percent for Social Security and 1.45 percent for Medicare, a combined 7.65 percent employer share, on top of what the caregiver takes home. The Social Security portion applies up to a wage base of $184,500 in 2026, which a home care wage will not reach. Source: IRS Tax Topic 751, read September 10, 2026.

State unemployment insurance is also owed, at a rate set per employer, and those per-employer rates are not published. So even the tax side of the rate stops being measurable after the federal share.

The components with no published rate

Each of these is a real cost of putting a caregiver in a house for an hour. None of them has a public dataset behind it, in this metro or any other.

• Workers compensation insurance on the caregiver.
• General and professional liability insurance on the business.
• Recruiting, background screening and training before a first shift.
• Scheduling, and the supervisor who covers a call-off at six in the morning.
• Paid time that is not billed, including travel between clients on some schedules.
• Office overhead, software, and the phone somebody answers on a Sunday.
• Margin, without which the business stops existing.

You will find articles that assign a percentage to each of those. They are estimates. This desk does not publish estimates, so this page ends without a breakdown, on purpose.

What to ask instead of guessing

You cannot verify an agency's cost structure. You can pin down how the rate behaves, and that is what changes a monthly budget. Ask these before you agree to anything.

• What is the minimum shift, and is there a weekly hour minimum?
• Does the rate change for nights, weekends, or holidays?
• Does a live-in or overnight shift bill differently from an hourly shift?
• What happens to the bill when a caregiver calls off and a substitute covers?
• Is mileage or errand time billed, and at what point?
• How much notice do you need to cancel a shift without being charged?
• How and how often is the invoice produced, and what does one look like?

Every one of those has an answer the agency already knows. Write the answers down. Two quotes with the same hourly number can produce very different monthly totals once the minimums and the cancellation terms are on paper.

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Next
Where the $14.28 sits against every other care occupation in the metro
Sources and pull dates