What is included in the agency hourly rate for home care?

The single most common cost surprise for Southeast Michigan families is discovering that the caregiver’s wage is only about half of the agency’s hourly rate. The other half is the infrastructure that keeps the schedule reliable and the family protected: payroll tax (FICA, Medicare, unemployment), workers compensation insurance, general liability and professional liability coverage, and errors-and-omissions coverage.

On top of insurance and tax, the rate funds vetting and training: ICHAT background check, national sex-offender registry, OIG exclusion check, drug screening, driver-record pull, HIPAA and universal-precautions training, dementia and transfer skill verification by a Registered Nurse. That vetting is what keeps the agency licensed by LARA and the family off the hook if something goes wrong.

Ongoing infrastructure is the third bucket: a care coordinator managing the case, an RN supervising clinical questions, a scheduler filling shifts, a backup roster ready when the primary caregiver is sick, 24/7 phone support, and payroll processing. That is why Companion Care runs $27–$32/hr and Personal Care runs $29–$37/hr at typical 2026 Southeast Michigan agency rates, not $18–$22.

Private hire looks cheaper because it is invoiced net of those items — but the family absorbs each one. A single injury on shift with no workers comp is often the last time a family chooses private hire.

For the full breakdown, see the cornerstone: Understanding Home Care Costs in Michigan.