OMB Control Number 0985-0054

Expiration Date: 02/29/2020

CASE COMPONENT DATA

 PRA Public Burden Statement:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of 

information unless such collection displays a valid OMB control number (OMB 0985-0054). Public 

reporting burden for this collection of information is estimated to average per response as follows for each 

component of the collection: Agency Component – 7 hours; Key Indicator Component – 32 hours; Case 

Component – 125 hours. These estimates include the time for gathering and maintaining the data needed and 

completing and reviewing the collection of information. The obligation to respond to this collection is 

voluntary. Send comments regarding the burden estimate or any other aspect of this collection of 

information, including suggestions for reducing this burden, to the Administration for Community Living, 

U.S. Department of Health and Human Services, 330 C Street, SW, Washington, DC 20201-0008, Attention: 

Stephanie Whittier Eliason, at 202.795.7467 and Stephanie.WhittierEliason@acl.hhs.gov
C-1

Case: The Case Component data is submitted by uploading a data file to the NAMRS website annually. Specific 

instructions will be provided to states on the data file formatting. The reporting period is the federal fiscal year 

(October–September).

Table 1–Investigation Entity

Each reporting period submission may have multiple investigations.

Element

No.

Element

Name

Element Description Required Cardinality Type/Format Code Values

Inv1 Investigation ID The unique identifier used by

the state for each investigation. 

The identifier is assigned to a 

specific investigation and is

only used once. The

Investigation ID is encrypted by 

the state for purposes of data 

submission.

Yes Single Encoded ID Not applicable

Inv2 Report date The month, day, and year the

agency was notified of the 

suspected adult maltreatment.

No Single Date

yyyy-mm-dd

Not applicable

Inv3 Report source The role or profession of the 

person who made the report of 

the suspected adult 

maltreatment. Multiple report 

source code values can be 

submitted for the client.

No Multiple Enumeration

(code)

1 = substitute decision 

maker

2 = in-home caregiver

3 = nursing home staff

4 = residential care 

community staff

5 = education professional

6 = financial professional

7 = law enforcement, 

judicial, or legal 

professional

8 = medical or health

professional

9 = mental and behavioral 

health professional

10 = social services 

professional

11 = other professional

12 = relative

13 = neighbor, friend, 

other nonrelative, other 

nonprofessional

14 = self

15 = no role identified

Inv4 State/county

FIPS code of 

investigative 

agency

The Federal Information

Processing Series for state (2 

digits) and county code (3 

digits) of the APS agency. 

(Primary agency responsible 

for the determination of the 

investigation)

No Single FIPS (#####) Code is the unique

identification number 

assigned to each state and 

county under the Federal 

Information Processing 

Standards (FIPS) 

guidelines. See

http://www.census.gov/geo

/www/fips/fips.html
C-2

Element

No.

Element

Name

Element Description Required Cardinality Type/Format Code Values

Inv5 Investigation

start date

The date the investigation is

assigned to an investigation 

worker. If the agency uses 

another date to indicate the 

start of an investigation, that 

date is used.

No Single Date

yyyy-mm-dd

Not applicable

Inv6 Investigation 

disposition 

date

The date that the agency 

completed dispositions on the 

allegations of maltreatment 

associated with the 

investigation.

No Single Date

yyyy-mm-dd

Not applicable

Inv7 Case closure

date

The date that the agency

completed all activities related 

to the investigation of the case.

Yes Single Date

yyyy-mm-dd

Not applicable

Table 2–Client Entity

Each investigation may have multiple clients. Each client can be associated with more than one investigation but 

a separate client entity is required for each investigation.

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt1 Client ID The unique identifier used by

the state for each client. The 

identifier is assigned to a 

specific client and is used 

identify the same client 

across investigations and 

reporting periods. The client 

ID is encrypted by state for

purposes of data submission. 

Data on multiple clients can 

be submitted for the 

investigation.

Yes Single Encoded ID Not applicable
C-3

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt2 Maltreatment

setting

The location where the

alleged maltreatment 

occurred.

No Single Enumeration

(code)

10 = own residence or

private residence of 

relative or caregiver

20 = residential care 

community (non-specific)

21 = licensed residential 

care community

22 = unlicensed 

residential care 

community

30 = nursing home (nonspecific)

31 = licensed nursing 

home

32 = unlicensed nursing 

home

40 = adult day services 

center (non-specific)

41 = licensed adult day 

services center

42 = unlicensed adult 

day services center

50 = place of business or 

other services

60 = other

Clt3 State/county

FIPS code of 

client

The Federal Information

Processing Series for state (2 

digits) and county code (3 

digits) of the client’s

residence at the start of the 

investigation.

No Single FIPS (#####) Code is the unique

identification number 

assigned to each state 

and county under the 

Federal Information 

Processing Standards 

(FIPS) guidelines. See

http://www.census.gov/ge

o/www/fips/fips.html
C-4

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt4 Case closure

reason

The primary reason why the

case was closed.

No Single Enumeration

(code)

10 = investigation

completed

20 = investigation 

completed and protective 

services case completed

30 = investigation unable 

to be completed (nonspecific)

31 = investigation 

unable to be completed 

due to death of client 

during investigation

32 = investigation 

unable to be completed 

due to refusal of client

40 = protective services 

case opened but not 

completed (non-specific)

41 = protective services 

case closed due to death 

of client

42 = protective services 

case closed due to client 

decision to not continue

50 = other

Clt5 Age The age of the client in years

(at investigation start date).

No Single Enumeration

(code)

18,19...74 = actual age

75 = 75 through 84

85 = 85 and older

Clt6 Gender identity The actual or perceived 

gender-related characteristics 

of the client.

No Single Enumeration

(code)

1 = male

2 = female

3 = transgender

Clt7 Sexual 

orientation

The client’s enduring pattern

of or disposition to experience 

sexual or romantic desires

for, and relationships with, 

people of one’s same sex, the 

other sex, or both sexes.

No Single Enumeration

(code)

1 = straight

2 = gay/lesbian

3 = bisexual

4 = questioning

5 = other
C-5

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt8 Race The population(s) or group(s)

that the client identifies as 

being a member. A client may 

have more than one race 

(multi-racial). For example, if

a client is Asian and White, the

client should be reported with

both race values. If specific

races cannot be identified for

a multiracial client, the client is

reported as “Other”.

No Multiple Enumeration

(code)

10 = American Indian or

Alaska Native

20 = Asian (non-specific)

21 = Asian Indian

22 = Chinese

23 = Filipino

24 = Japanese

25 = Korean

26 = Vietnamese

27 = Other Asian

30 = Black or African

American

40 = Native Hawaiian or 

Other Pacific Islander 

(non-specific)

41 = Native Hawaiian

42 = Guamanian or

Chamorro

43 = Samoan

44 = other Pacific

Islander

50 = White

60 = Other

Clt9 Ethnicity The affiliation of the client as

Hispanic or Latino/a or nonHispanic or Latino/a. Multiple 

ethnicity code values can be 

submitted for the client.

No Multiple Enumeration

(code)

10 = yes, Hispanic or

Latino/a, or Spanish origin

(non-specific)

11 = Mexican, Mexican

American, Chicano/a

12 = Puerto Rican

13 = Cuban

14 = other Hispanic, 

Latino/a, or Spanish origin

20 = no, not Hispanic or

Latino/a, or Spanish origin

Clt10 Primary

language

The primary language or

method that the client uses 

for written and verbal 

communication.

No Single Enumeration

(code)

1 = Arabic

2 = Chinese

3 = English

4 = French

5 = German

6 = Korean

7 = Russian

8 = Spanish or Spanish

Creole

9 = Tagalog

10 = Vietnamese

11 = sign language

12 = assistive technology

13 = other
C-6

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt11 Marital status The client’s status based on

state residency laws.

No Single Enumeration

(code)

1 = never married

2 = married

3 = domestic partner, 

including civil union

4 = divorced

5 = separated

6 = widowed

7 = other

Clt12 Schooling level The highest educational

degree attained by the client.

No Single Enumeration

(code)

1 = less than high school

2 = high school diploma or 

equivalent

3 = associate’s degree or 

bachelor’s degree

4 = advanced degree

Clt13 Employment

status

The involvement of the client

in the labor force.

No Single Enumeration

(code)

1 = employed

2 = unemployed

3 = not in labor force

4 = other

Clt14 Income level The level of annual income of

the client including all sources 

of income.

No Single Enumeration

(code)

1 = less than $25,000

2 = $25,000-$49,999

3 = $50,000-$74,999

4 = $75,000-$99,999

5 = $100,000 or more

Clt15 Benefits The federal and state benefits

received by the client during 

the investigation. Multiple 

benefit code values can be 

submitted for the client.

No Multiple Enumeration

(code)

1 = Medicaid

2 = Medicare

3 = publicly-subsidized 

housing

4 = Social Security 

Disability Insurance 

(SSDI)

5 = Social Security 

retirement benefits

6 = Supplemental Security

Income (SSI)

7 = Temporary Assistance 

for Needy Families

(TANF)

8 = veterans’ disabled 

benefits

9 = other

Clt16 Veteran status The client’s status related to

the US Armed Forces.

No Single Enumeration

(code)

1 = veteran

2 = non-veteran
C-7

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt17 Disabilities The client’s physical,

emotional, and mental health 

issues that result in limitation 

in activities and restrictions to 

fully participate at school, 

work, or in the community. 

Multiple disability code values 

can be submitted for the

client.

No Multiple Enumeration

(code)

1 = ambulatory difficulty

2 = cognitive difficulty

3 = communication 

difficulty

4 = hearing difficulty

5 = independent living 

difficulty

6 = self-care difficulty

7 = vision difficulty

8 = other

9 = none

Clt18 ADL score The client’s score on the Katz

Index of Independence in 

Activities of Daily Living 

(ADL).

No Single Numeric

(6 integers)

Permissible values are

0-6

Clt19 IADL score The client’s score on the

Lawton Instrumental Activities 

of Daily Living (IADL).

No Single Numeric

(6 integers)

Permissible values are

0-8

Clt20 Behavioral 

health 

screenings or 

diagnoses

The results of assessments 

on the client, conducted by 

the APS agency. Multiple

behavioral health code values 

can be submitted for the

client.

No Multiple Enumeration

(code)

1 = alcohol use disorder

2 = anxiety

3 = bipolar disorder

4 = dementia

5 = depression

6 = schizophrenia and 

other psychotic disorders

7 = substance use

disorder

8 = traumatic brain injury

9 = other

10 = none

Clt21 Living setting at

start

The primary residential

environment of the client at 

the start of investigation.

No Single Enumeration

(code)

10 = own residence or

residence of relative or 

caregiver

20 = residential care 

community (non-specific)

21 = licensed 

residential care 

community

22 = non-licensed 

residential care 

community

30 = nursing home (nonspecific)

31 = licensed nursing 

home

32 = non-licensed

nursing home

40 = other
C-8

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt22 Living setting at

close

The primary residential

environment of the client at 

the time of case closure.

No Single Enumeration

(code)

10 = own residence or

residence of relative or 

caregiver

20 = residential care

community (non-specific)

21 = licensed residential 

care community

22 = non-licensed 

residential care 

community

30 = nursing home (nonspecific)

31 = licensed nursing 

home

32 = non-licensed

nursing home

40 = other

Clt23 Substitute 

decision makers 

at start

The authorizations that are in 

effect related to health, 

personal, or financial decision 

making for the client at the 

start of the investigation. 

Multiple substitute decision 

maker code values can be 

submitted for the client.

No Multiple Enumeration

(code)

10 = health care proxy in 

effect

20 = financial proxy in 

effect

30 = guardianship or 

conservatorship (nonspecific)

31 = guardianship or

conservatorship of person

32 = guardianship or 

conservatorship of 

property

40 = representative payee

50 = none

Clt24 Substitute

decision makers 

at close

The authorizations that are in

effect related to health, 

personal, or financial decision 

making for the client at time

of case closure. Multiple 

substitute decision maker 

code values can be submitted 

for the client.

No Multiple Enumeration

(code)

10 = health care proxy in

effect

20 = financial proxy in 

effect

30 = guardianship or 

conservatorship (nonspecific)

31 = guardianship or

conservatorship of person

32 = guardianship or 

conservatorship of 

property

40 = representative payee

50 = none
C-9

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt25 Services at start The services known to the

agency that the client was 

already receiving at the start 

of the investigation. Multiple 

service code values can be 

submitted for the client.

No Multiple Enumeration

(code)

1 = care/case

management services

2 = caregiver support 

services

3 = community day 

services

4 = education, 

employment, and training 

services

5 = emergency assistance

and material aid services

6 = financial planning 

services

7 = housing and relocation 

services

8 = in-home assistance 

services

9 = legal services

10 = medical and dental 

services

11 = medical rehabilitation 

services

12 = mental health 

services

13 = nutrition

14 = public assistance 

benefits

15 = substance use 

services

16 =transportation

17 = victim services

18 = other services

19 = none
C-10

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt26 Services APS The services that the agency

provided on behalf of the client

during the investigation or 

while the agency kept an open

case. Multiple service code

values can be submitted for

the client.

No Multiple Enumeration

(code)

1 = care/case

management services

2 = caregiver support 

services

3 = community day 

services

4 = education, 

employment, and training 

services

5 = emergency assistance

and material aid services

6 = financial planning 

services

7 = housing and relocation 

services

8 = in-home assistance 

services

9 = legal services

10 = medical and dental 

services

11 = medical rehabilitation 

services

12 = mental health 

services

13 = nutrition

14 = public assistance 

benefits

15 = substance use 

services

16 =transportation

17 = victim services

18 = other services

19 = none
C-11

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt27 Services referred The services for which the

agency referred the client. 

Multiple services code values 

can be submitted for the 

client.

No Multiple Enumeration

(code)

1 = care/case

management services

2 = caregiver support 

services

3 = community day 

services

4 = education, 

employment, and training 

services

5 = emergency assistance

and material aid services

6 = financial planning 

services

7 = housing and relocation 

services

8 = in-home assistance 

services

9 = legal services

10 = medical and dental 

services

11 = medical rehabilitation 

services

12 = mental health 

services

13 = nutrition

14 = public assistance 

benefits

15 = substance use 

services

16 =transportation

17 = victim services

18 = other services

19 = none
C-12

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Clt28 Services at close The services known to the

agency that the client was 

receiving at the time of case 

closure. Multiple services

code values can be submitted 

for the client.

No Multiple Enumeration

(code)

1 = care/case

management services

2 = caregiver support 

services

3 = community day 

services

4 = education, 

employment, and training 

services

5 = emergency assistance

and material aid services

6 = financial planning 

services

7 = housing and relocation 

services

8 = in-home assistance 

services

9 = legal services

10 = medical and dental 

services

11 = medical rehabilitation 

services

12 = mental health 

services

13 = nutrition

14 = public assistance 

benefits

15 = substance use 

services

16 =transportation

17 = victim services

18 = other services

19 = none

Clt29 Interagency 

coordination

The agencies to which the 

client was referred. Multiple 

interagency coordination

code values can be submitted 

for the client.

No Multiple Enumeration

(code)

1 = law enforcement or 

prosecutorial offices

2 = Protection and 

Advocacy or Client 

Advocacy Program (CAP)

3 = state licensing agency

4 = State Medicaid Fraud

Control Unit (MFCU)

5 = Long Term Care

Ombudsman Program

6 = other

7 = none

Clt30 Previous report The indication that the

agency has information that 

the client was the subject of a 

previous report.

No Single Enumeration

(code)

1 = yes

2 = no
C-13

Table 3–Maltreatment Allegation Entity

Each client may have multiple maltreatment allegation entities within a specific investigation but only one of a 

particular maltreatment type. Each maltreatment allegation entity is associated with only one client. Each

maltreatment allegation entity must be composed of a maltreatment type and maltreatment disposition.

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Mal1 Maltreatment type The alleged maltreatments

that are investigated.

Yes Single (per

entity)

Enumeration

(code)

10 = abandonment

20 = emotional abuse

30 = exploitation (nonspecific)

31= financial exploitation

32= other exploitation

40 = neglect

50 = physical abuse

60 = sexual abuse

70 = suspicious death

80 = self-neglect

90 = other

Mal2 Maltreatment

disposition

The disposition of each

alleged maltreatment.

Yes Single (per

entity)

Enumeration

(code)

1 = substantiated

2 = inconclusive

3 = unsubstantiated

4 = other

Table 4–Perpetrator Entity

Each investigation may have zero, one, or more than one perpetrator. A perpetrator must be associated with at 

least one substantiated maltreatment investigation that is associated with a specific client within the investigation. 

A perpetrator may be associated with more than one investigation but a separate perpetrator entity is required for 

each of the associated investigations.

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Per1 Perpetrator ID The unique identifier used by 

the state for the person who 

is found to be responsible for 

substantiated

maltreatment(s). The identifier 

is assigned to a specific 

perpetrator and is used to 

identify the same perpetrator 

across investigations and 

reporting periods. The 

Perpetrator ID is encrypted by 

the state for purposes of data 

submission.

Yes Single Encoded ID Not applicable
C-14

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Per2 Age The age of the perpetrator in

years (at investigation start 

date).

No Single Enumeration

(code)

17 = 17 and younger

18,19...74 = actual age

75 = 75 through 84

85 = 85 and older

Per3 Gender identity The actual or perceived

gender-related characteristics 

of the perpetrator.

No Single Enumeration

(code)

1 = male

2 = female

3 = transgender

Per4 Race The population(s) or group(s)

that the perpetrator identifies 

as being a member. A 

perpetrator may have more 

than one race (multi-racial). 

For example, if a perpetrator 

is Asian and White, the 

perpetrator should be 

reported with both race 

values. If specific races 

cannot be identified for a 

multiracial perpetrator, the 

perpetrator is reported as 

“Other”.

No Multiple Enumeration

(code)

10 = American Indian or

Alaska Native

20 = Asian (non-specific)

21 = Asian Indian

22 = Chinese

23 = Filipino

24 = Japanese

25 = Korean

26 = Vietnamese

27 = Other Asian

30 = Black or African

American

40 = Native Hawaiian or 

Other Pacific Islander 

(non-specific)

41 = Native Hawaiian

42 = Guamanian or

Chamorro

43 = Samoan

44 = other Pacific

Islander

50 = White

60 = Other

Per5 Ethnicity The affiliation of the 

perpetrator as Hispanic or 

Latino/a or non-Hispanic or 

Latino/a. Multiple ethnicity 

code values can be submitted 

for the perpetrator.

No Multiple Enumeration

(code)

10 = yes, Hispanic or 

Latino/a, or Spanish origin 

(non-specific)

11 = Mexican, Mexican

American, Chicano/a

12 = Puerto Rican

13 = Cuban

14 = other Hispanic, 

Latino/a, or Spanish origin

20 = no, not Hispanic or

Latino/a, or Spanish origin
C-15

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

Per6 Disabilities The perpetrator's physical,

emotional, and mental health 

issues that result in limitation 

in activities and restrictions to 

fully participate at school, 

work, or in the community. 

Multiple disability code values 

can be submitted for the 

perpetrator.

No Multiple Enumeration

(code)

1 = ambulatory difficulty

2 = cognitive difficulty

3 = communication 

difficulty

4 = hearing difficulty

5 = independent living 

difficulty

6 = self-care difficulty

7 = vision difficulty

8 = other

9 = none

Per7 Behavioral health

screenings or 

diagnoses

The results of assessments

on the perpetrator, conducted 

by the APS agency. Multiple 

behavioral health code values 

can be submitted for the 

perpetrator.

No Multiple Enumeration

(code)

1 = alcohol use disorder

2 = anxiety

3 = bipolar disorder

4 = dementia

5 = depression

6 = schizophrenia and 

other psychotic disorders

7 = substance use 

disorder

8 = traumatic brain injury

9 = other

10 = none

Table 5–Client Perpetrator Relationship Entity

Each client and perpetrator can have a designated relationship if data on one or more of the entity attributes is 

provided. A client and perpetrator have only one relationship entity within an investigation.

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

CPR1 Cohabitation at

start

The indication if the

perpetrator and client are 

cohabitating at the start of the 

investigation.

No Single Enumeration

(code)

1 = yes

2 = no

CPR2 Cohabitation at

close

The indication if the

perpetrator and client are 

cohabitating at the time of 

case closure.

No Single Enumeration

(code)

1 = yes

2 = no
C-16

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

CPR3 Kinship

relationship

The indication if the

perpetrator is related to the 

client by affinity (blood, 

adoption, marriage, etc.).

No Single Enumeration

(code)

10 = yes (non-specific)

11 = spouse

12 = domestic partner, 

including civil union

13 = parent

14 = child

15 = sibling

16 = grandparent

17 = grandchild

18 = other relative

20 = none

CPR4 Perpetrator

association at 

start

The indication if the

perpetrator has a caregiving 

relationship to the client at the 

start of the investigation.

No Single Enumeration

(code)

10 = nursing home staff

20 = residential care 

community staff

30 = relative caregiver

(non-specific)

31 = paid relative 

caregiver

32 = unpaid relative 

caregiver

40 = nonrelative 

caregiver (non-specific)

41 = paid nonrelative 

caregiver

42 = unpaid nonrelative

caregiver

50 = other relationship

60 = none

CPR5 Perpetrator 

association at 

close

The indication whether the 

perpetrator has a caregiving 

relationship to the client at 

time of case closure.

No Single Enumeration

(code)

10 = nursing home staff

20 = residential care 

community staff

30 = relative caregiver

(non-specific)

31 = paid relative 

caregiver

32 = unpaid relative 

caregiver

40 = nonrelative 

caregiver (non-specific)

41 = paid nonrelative 

caregiver

42 = unpaid nonrelative 

caregiver

50 = other relationship

60 = none
C-17

Element

No.

Element Name Element Description Required Cardinality Type/Format Code Values

CPR6 Perpetrator

substitute 

decision maker 

at start

Authorizations that the

perpetrator has in relation to 

the client, and that are in 

effect, related to health, 

personal or financial decision 

making at the start of the 

investigation. Multiple 

substitute decision maker 

code values can be submitted 

for the client perpetrator 

relationship.

No Multiple Enumeration

(code)

10 = health care proxy in

effect

20 = financial proxy in 

effect

30 = guardianship or 

conservatorship (nonspecific)

31 = guardianship or 

conservatorship of 

person

32 = guardianship or 

conservatorship of 

property

40 = representative 

payee

50 = none

CPR7 Perpetrator

substitute 

decision maker 

at close

Authorizations that the

perpetrator has in relation to 

the client, and that are in 

effect, related to health, 

personal or financial decision 

making at the time of case 

closure. Multiple substitute 

decision maker code values 

can be submitted for the client 

perpetrator relationship.

No Multiple Enumeration

(code)

10 = health care proxy in

effect

20 = financial proxy in 

effect

30 = guardianship or 

conservatorship (nonspecific)

31 = guardianship or 

conservatorship of 

person

32 = guardianship or 

conservatorship of 

property

40 = representative 

payee

50 = none

CPR8 Perpetrator legal

remedy 

recommendation

The legal remedies that were

recommended or sought by 

the APS agency regarding the 

status of the perpetrator. 

Multiple legal remedy 

recommendation code values 

can be submitted for the client 

perpetrator relationship.

No Multiple Enumeration

(code)

1 = removal of

guardianship rights

2 = restraining order on 

perpetrator regarding the 

client

3 = eviction of 

perpetrator

4 = restitution by 

perpetrator

5 = other legal remedy

6 = none