How to read a caregiver-supply map for your county

Start with the unit. The supply page on this desk is not a list of caregivers, not a list of open shifts, and not a wait-time. It is a count of private establishments classified under NAICS 621610, home health care services, placed against a count of residents aged 65 and over. The establishment count comes from the Bureau of Labor Statistics Quarterly Census of Employment and Wages for 2024 Q4. The population count comes from the Census Bureau Vintage 2024 county characteristics files, the YEAR 6 row, which is the estimate for July 1, 2024.

Those two files were not built to answer each other. This desk divides one by the other so you can see, county by county, how thick or thin registered presence runs against the older population. Across the fifteen counties of the St. Louis MO-IL region the file reports 409 establishments against 535,836 residents aged 65 and over, a regional rate of 0.76 per 1,000. That regional figure is a backdrop, not a target your county is supposed to meet.

One industry caveat belongs in the first screen, not a footnote. NAICS 621610 mixes medical and non-medical home care into a single code. A Medicare certified skilled agency and a company that sends a caregiver to help with bathing, meals and errands sit in the same column. No public column separates them. When you read a county's rate, you are reading registered business presence in that mixed code, not a count of the specific service you may be trying to hire.

Open the supply ranking. The sort is ascending: fewest establishments per 1,000 older adults first. That is deliberate. A ranking that put the densest county at the top would hide the thin end, which is the question the page was built to answer. Your county's position is a place in that order, not a grade.

Read four cells before you read the rate. First, the establishment count. Second, the employment count, which may say withheld. Third, the number of residents aged 65 and over. Fourth, the rate. The rate is this desk's construction. The three inputs are published. If a cell says "no row published" or "not computed", stop there. Those phrases are the finding. They are not a gap waiting for a zero.

Confirm you have the right jurisdiction. St. Louis County and the independent city of St. Louis are separate rows. Their figures are not combined anywhere on this site, and adding them would merge two governments that keep separate records. If the person you are planning for lives in an unincorporated part of the county, you still read the county row. This desk does not publish municipality figures. Ballwin, Chesterfield and Valley Park are not in the file this ratio stands on.

A low rate means few establishments are registered in that county relative to the older population living there. Jefferson County is the lowest computed figure on the page: 3 establishments against 41,443 residents aged 65 and over, a rate of 0.07 per 1,000. St. Charles County, with the second largest older population in the region at 76,887, reports 35 establishments and a rate of 0.46. Warren County reports one establishment against 7,504 residents aged 65 and over, a rate of 0.13. Those are different kinds of thin. One is a large county with almost no registered offices. One is a large county with some offices and still a low rate. One is a smaller county with a single reported employer.

Compare those rows with the two urban cores before you decide what the gap means. St. Louis County reports 242 establishments and a rate of 1.21. The city of St. Louis reports 77 and a rate of 1.64, the highest in the region. Together those two rows hold 319 of the 409 establishments the file reports, against 46 percent of the region's older population. The industry is registered where the offices are, which is not always where the older adults are.

That last clause is the one that changes how you hire. QCEW counts establishments where they are registered as employers. A company with an office in St. Louis County routinely sends staff into neighbouring counties. A low Jefferson County rate describes where employers are based. It does not, by itself, prove that no caregiver from another county will take an assignment there. The practical check is the provider's own published service area against the address, which is a different document from this table.

Five Illinois counties have no NAICS 621610 row in the 2024 Q4 file at all: Calhoun, Bond, Jersey, Monroe and Macoupin. Together they hold 26,394 residents aged 65 and over. This desk shows them as no row published and does not compute a rate. That handling is not a courtesy. QCEW still publishes an establishment count when it withholds employment under disclosure code N. You can see that split three times on the same table, in Warren, Clinton and Lincoln counties, where the establishment cell has a number and the employment cell says withheld. An entirely absent row is therefore a different event from a suppressed figure. Treating it as zero would invent a measurement the file did not make.

If your county is one of those five, you do not have a supply ratio to quote. You have an absence in one industry file. People still live there. Help may still be organised from an office across a county line. The map's honest statement is that BLS did not publish a 621610 row for that county in that quarter, and this desk will not fill the hole.

Establishments count offices. Employment counts the people on those payrolls in December 2024. The two orders disagree, which is why this desk publishes them on separate pages. On the establishment ranking, the city of St. Louis leads at 1.64 per 1,000 and St. Louis County follows at 1.21. Ranked on jobs per 1,000 older adults, St. Louis County leads at 25.2, St. Clair County, Illinois, is second at 24.8, and the city drops to third at 20.2. The city has many small employers: 77 establishments and 949 jobs. St. Clair County has fewer, larger ones: 27 establishments and 1,153 jobs.

St. Charles County moves the other way. It sits well above Jefferson County on establishments, at 0.46 per 1,000, and drops on jobs to 6.8 per 1,000, because its 35 establishments employ 524 people. Jefferson County is last on both published measures: 86 jobs against 41,443 residents aged 65 and over, 2.1 per 1,000. Only seven of the fifteen counties have a published employment figure. The other eight, holding 51,444 residents aged 65 and over, are listed as withheld or as no row, never as zero. If you only read the establishment map, you miss that second story. Read the jobs page next to the supply page, not instead of it.

Write down three facts from your county's row: the establishment count, the rate if one was computed, and whether employment is published, withheld, or absent. Then write down the population aged 65 and over, so you remember the size of the denominator. A rate of 0.07 on 41,443 older adults is a different planning problem from a missing row on 1,077 older adults, even though both sit at the thin end of the same table.

Use the county row as a briefing, not as a hiring list. If you live in another city, the map tells you how concentrated registered offices are. It does not tell you who will answer the phone. A long-distance family often needs a week-by-week checklist such as Far Away Daughter. If the question in the house is whether staying home is organisable, that work is the subject of Keep Her Home. Neither guide is a data file. This page is not a care plan.

Then look up the provider, not the county. Ask for the legal name, ask which towns they actually serve, and ask whether they are a licensed home health agency or a non-medical company. This desk does not rate, score or match anyone. It publishes the join of two public files. The Census Bureau documents how the population side is produced in its population estimates methodology. The rest of the column codes, the YEAR 6 filter and the reason a figure is shown as not published rather than as zero are on the methodology page.