Adult

Maltreatment

Report | 2018
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 2

Report Preparation

This report was prepared for the U.S. Administration for Community Living, Administration on 

Aging, Department of Health and Human Services by the Adult Protective Services Technical 

Assistance Resource Center operated by WRMA, Inc.

Public Domain Notice

Material contained in this publication is in the public domain and may not be reproduced, fully or 

partially, without permission of the federal government. 

Electronic Access

This report is available on the Administration for Community Living website at https://acl.gov/

programs/elder-justice/national-adult-maltreatment-reporting-system-namrs

For Questions and More Information

If you have questions or require additional information about this report, please contact the APS 

Technical Assistance Resource Center (APS TARC) at apstarc-ta@acl.hhs.gov. 

Federal Contact

Stephanie Whittier Eliason, MSW

Office of Elder Justice and Adult Protective Services 

Administration on Aging/Administration for Community Living

U.S. Department of Health & Human Services

Mary E. Switzer Building

330 C Street SW

Washington, D.C. 20201

stephanie.whittiereliason@acl.hhs.gov

About This Report

About This Report | i
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 3

In communities around the country, adult protective services (APS) staff, administrators, and 

advocates work diligently to ensure the safety and well-being of adults who are maltreated by 

others or who are unable to care for themselves. Understanding the nature and extent of adult 

maltreatment—and the ways APS programs respond to it—is critical to enhancing the effectiveness 

of APS programs. To that end, we are pleased to release the Adult Maltreatment Report 2018.

The U.S. Department of Health and Human Services, Administration for Community Living (ACL), 

in partnership with the Adult Protective Services Technical Assistance Resource Center (APS 

TARC), is committed to advancing the APS field through data analysis, evaluation, and technical 

assistance—all to support improved services and better outcomes in APS programs. The National 

Adult Maltreatment Reporting System (NAMRS) is a key part of this effort. 

This is the third edition of the report and is the first time all reporting jurisdictions have participated. 

Since adult maltreatment continues to increase, it is important that we continue to focus on quality 

improvements to strengthen the collective understanding of adult maltreatment. 

This report would not be possible without the time, effort, and dedication of state and local APS 

field staff who document their cases, program staff who map agency documentation to NAMRS, 

information technology staff who generate and upload reports to NAMRS, and other agency 

personnel who lead and support them. We gratefully acknowledge the efforts of all involved to 

make this report possible. We will continue to do everything we can to promote the safety and 

well-being of maltreated adults across our nation. 

Sincerely, 

The APS TARC Team

Letter from the APS TARC Team

Letter from the APS TARC Team | ii
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 4

The Administration for Community Living gratefully acknowledges the voluntary submission of 

data to the National Adult Maltreatment Reporting System (NAMRS) by the states, the District of 

Columbia (D.C.), and U.S. Territories. This report would not be possible without the support of the 

adult protective services (APS) staff, supervisors, and program administrators in collecting and 

reporting data to NAMRS. 

Acknowledgements

Acknowledgements | iii

Suggested Citation

Aurelien, G., Beatrice, M., Cannizzo, J., Capehart, A., Gassoumis, Z., Urban, K. (2019). Adult 

Maltreatment Data Report 2018. Submitted to the Administration for Community Living, 

U.S. Department of Health and Human Services

Disclaimer 

NAMRS and the Adult Protective Services Technical Resource Center is a project (HHSP 

233201500042I) of the U.S. Administration for Community Living, Administration on Aging, 

Department of Health and Human Services, administered by the WRMA, Inc. Contractor’s 

findings, conclusions, and points of view do not necessarily represent U.S. Administration for 

Community Living, Administration on Aging, Department of Health and Human Services official 

policy.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 5

Table of Contents

Table of Contents | iv

Summary 1

Chapter 1: Report Overview 3

What is adult protective services? 3

What is NAMRS and how do I use the data in this report? 5

Chapter 2: Reports and Investigations of Maltreatment 7

What do we know about reports of maltreatment to APS? 7

How many investigations did APS programs conduct and how 

many clients and victims were there in those investigations? 8

How long does it take to investigate a case? 9

What are the case closure reasons for APS cases? 10

Chapter 3: Clients, Victims, and Perpetrators 11

What is the age of APS clients and victims? 11

What is the gender, race, and ethnicity of APS clients and victims? 12

What types of disabilities do APS clients and victims have? 13

How many APS clients and victims had previous reports to APS? 14

What are the living settings of APS clients? 15

What are the demographic characteristics of perpetrators? 16

What is the role of data in improving APS? 17

Conclusion 17

Appendix 18

A: Understanding APS Populations 18

B: What types of maltreatment does APS investigate? 19

C: What are key aspects of APS programs? 20

D: Overview of NAMRS 21

E: What types of intake models are used by APS? 22

F: When were maltreatment reports received? 23

G What was the setting of and who reported the alleged maltreatment? 24

H: What are the disposition rates in APS cases? 25

I: Tables 27
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 6

Table of Contents (Continued)

Table of Contents | v

Exhibits

Exhibit A: Growth in the Number of APS Investigations, Clients, and Victims 1

Exhibit B: FFY 2018 NAMRS Statistics at a Glance 2

Exhibit 1.1: APS Casework Practice Model 4

Exhibit 1.2: Submission of Components 5

Exhibit 1.3: Comparison of Key Indicators Component and Case Component Data 6

Exhibit 2.1: Total Maltreatment Reports 7

Exhibit 2.2: Source of Reported Maltreatment for APS Clients 7

Exhibit 2.6: Case Closure Reasons for APS Clients 10

Exhibit 3.1: APS Victims by Age Group 11

Exhibit 3.2: APS Clients andVictims by Gender 12

Exhibit 3.3: APS Clients and Victims by Race and Ethnicity 12

Exhibit 3.4: APS Clients and Victims by Type of Disability 13

Exhibit 3.5: Percent of APS Clients and Victims with a Previous APS Report 14

Exhibit 3.6: Maltreatment Types by All Victims and Victims with a Previous Report 14

Exhibit 3.7: Client Living Settings at the Start and Close of an APS Case 15

Exhibit 3.8: Perpetrators by Age Group 16

Exhibit A.1: Eligible Populations by State 18

Exhibit C.1: Standard of Evidence 20

Exhibit D.1: Key Definitions of NAMRS Data Elements 21

Exhibit E.1: Percentage of States by Type of Hotline Models 22

Exhibit F.1: Monthly Distribution of Accepted Reports 23

Exhibit G.1: Setting of Reported Maltreatment for APS Clients 24

Exhibit H.1: Maltreatment Disposition Types: Definitions and Percent of Clients by Type of 

Disposition 25

Exhibit H.2: Percent of Clients by Disposition Type and by Maltreatment Type 26

Table 1 – Substantiated Maltreatment Type by Case Closure Reason 27

Table 2 – Victim Maltreatment Type by Age Group 28

Table 3 – Victim Maltreatment by Gender Identity 29

Table 3 – Victim Maltreatment by Gender Identity 29

Table 4 – Victim Maltreatment Type by Race 30

Table 5 – Victim Maltreatment Type by Ethnicity 31

Table 6 – Victim Maltreatment Type by Race/Ethnicity 32

Table 7 – Victim Maltreatment Type by Disability 33

Table 8 – Victim Maltreatment Type by Previous Report 34

Table 9 – Maltreatment Type by Perpetrator Age Group 35

Table 10 – Maltreatment Type by Perpetrator Gender Identity 36
Adult Maltreatment Data Report 2018 Summary | 1

Summary

All 50 states, the District of Columbia, and the 

U.S. Territories (referred to as states or programs 

hereafter) provide adult protective services (APS) to 

respond to reports of maltreatment of adults.

Most state APS programs operate within the basic 

framework outlined in the nearby Elder Justice Act 

definition—receiving reports of alleged maltreatment, 

investigating the allegations, and planning and 

arranging or providing services and remedies to 

address the maltreatment. Within this framework, 

however, there is much diversity across APS programs 

in terms of population served, policy and practice, 

and available resources.

This report provides an overview of adult 

maltreatment as reported to APS programs, drawing 

primarily on federal fiscal year (FFY) 2018 data from 

the National Adult Maltreatment Reporting System 

(NAMRS). NAMRS is a federally sponsored effort, 

administered by the Administration for Community 

Living, to collect annual data on adult maltreatment 

from state APS programs.

FFY 2018 is the third year of NAMRS submissions. 

Exhibit A shows the trend in key data for the 44 states 

that have submitted data all three years. In FFY 2018, 

APS programs conducted 760,953 investigations for 

775,023 clients for a rate of 17.7 per 1,000 adults in 

the APS target population.1 The number of victims of 

substantiated allegations was 243,375 for a rate of 5.6 

victims per 1,000 adults in the target APS population. 

Exhibit B on the following page provides summary 

data and information on adult maltreatment as 

investigated by APS programs in FFY 2018. 

1 The APS target population is calculated by summing the population in

each state that is eligible for APS services.

15.2% Increase

Reports accepted for 

investigation nationwide 

in the last three years

The Elder Justice Act

The Elder Justice Act defines APS as 

services that include:

A) Receiving reports of adult abuse,

neglect, or exploitation;

B) Investigating the reports described

in subparagraph (A);

C) Case planning, monitoring,

evaluation, and other case work and

services; and

D) Providing, arranging for, or

facilitating the provision of medical,

social services, economic, legal,

housing, law enforcement, or other

protective, emergency, or support

services.

Exhibit A: Growth in the Number of 

APS Investigations, Clients, and Victims

2016 2017 2018

Investigations 671,981 698,156 715,107 

Clients 683,576 714,098 729,038 

Victims 217,742 229,208 230,564 

Notes: Percent increase in reports based on data submission by 49 

states. Number of investigations, clients, and victims is based on data 

submission by 44 states. States were excluded from this analysis if they 

did not submit data for all three years.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Summary | 2

Summary

Exhibit B: FFY 2018 NAMRS Statistics at a Glance
Adult Maltreatment Data Report 2018 Report Overview | 3

What is adult protective services?

This report provides an overview of adult maltreatment 

as reported to APS programs. It is primarily based on 

data reported by states, the District of Columbia, and 

U.S. Territories (“states” hereafter) to the National 

Adult Maltreatment Reporting System (NAMRS). 

APS is a social services program administered by state 

and local governments to serve adults who are alleged 

to have been abused, neglected, or exploited.

APS agencies investigate allegations of maltreatment, 

provide protective services, and coordinate with 

community and government partners to maximize the 

safety and independence of victims.

Establishment of Title XX of the Social Security Act 

of 1974 enabled many states to begin APS programs 

by providing, for the first time, federal funds for the 

protection of older adults. The Elder Justice Act, passed 

in 2010, was the first comprehensive federal legislation 

to address the abuse, neglect, and exploitation of 

older adults. The law authorizes a variety of programs 

and initiatives to better coordinate federal responses 

to elder abuse, promote elder justice research and 

innovation, support APS systems, and provide 

additional protection for residents of long-term care 

facilities.

While each state has its own laws and regulations to 

govern the operation of its APS programs, most follow 

a practice model similar to the one in Exhibit 1.1 on the 

following page. APS programs use age and the concept 

of disability (also referred to as “dependency” or 

“vulnerability”) to define the populations they serve. 

In some programs, as shown in Appendix A, being an 

older adult (age 60 or 65) is the only criterion for the 

population they serve; in others, it is a combination 

of age and disability. All programs that serve nonelderly individuals require disability as a criterion. APS 

programs investigate a variety of maltreatment types. 

Almost all programs investigate the maltreatment 

types of abuse, neglect, and exploitation, as shown in 

Appendix B. Appendix C provides information on some 

key administrative aspects (staffing, assessment tools, 

and standard of evidence) of APS programs.

To achieve the goals of APS programs, APS organizations 

rely on:

• Professional staff,

• Experts in areas such as physical and mental

health,

• Community partners such as the aging network

and law enforcement,

• Internal operational supports such as a case

management system and staff training,

• Funding for or referrals to services that assist

victims of maltreatment, and

• Legal and ethical frameworks designed to

protect the rights of alleged victims and alleged

perpetrators.

Goals of APS Programs

5) Ensure that victims of maltreatment are

safe

6) Respect independence and selfdetermination of clients

7) Reduce long-term cause of maltreatment

The Elder Justice Act is federal 

legislation that authorizes activities to 

improve APS programs.

Chapter 1: Report Overview
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Report Overview | 4

Chapter 1: Report Overview

Exhibit 1.1: APS Casework Practice Model
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Report Overview | 5

Chapter 1: Report Overview

What is NAMRS and how do I use the data in this report?

Exhibit 1.2: Submission of Components

The National Adult Maltreatment Reporting System 

(NAMRS) is the first comprehensive, national 

reporting system for state APS programs. States 

voluntarily submit data for each federal fiscal year 

(October – September). The goal of NAMRS is to 

collect consistent and accurate national data on 

investigations and services by APS programs.

The Adult Protective Services Technical Assistance 

Resource Center (APS TARC), funded by the 

Administration for Community Living (ACL), provides 

training and technical assistance to states to assist with 

NAMRS submissions. After approval by the U.S. Office 

of Management and Budget in March 2017, the first year 

of NAMRS reporting was FFY 2016. As a result of ACL 

system enhancement grants and APS TARC technical 

assistance, as shown in Exhibit 1.2, every state now 

participates and the number of states submitting 

detailed case data has increased every year. Exhibit 1.3, 

on the following page, provides an overview of the key 

aspects of NAMRS data components.

What is NAMRS?

NAMRS is a voluntary system for state 

APS programs to annually submit 

information on:

• The agency administering the APS 

program (Agency Component)

• Case Component (case-level) data or 

Key Indicators Component (summary 

statistics) on reports of allegations, 

investigations, clients, victims, and 

perpetrators and their relationships

 100% 

Of states participated 

in 2018 with 55% of 

states reporting

case-level data.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Report Overview | 6

Chapter 1: Report Overview

NAMRS is a modular and flexible system allowing 

states to submit APS data in a variety of ways. It 

provides states with options for submitting data 

– depending on the maturity of state information 

systems and resources to submit data. The NAMRS 

data in this report provide a national snapshot of key 

aspects of adult maltreatment as reported to APS 

programs. Each chapter describes key topics, provides 

key data highlights and discusses what they mean, 

and includes notes for understanding and interpreting 

the data. Even if a large number of states were not 

able to submit data for a particular data element, 

the submitted data may provide general, if not 

always representative, information on APS practices. 

Appendix D provides definitions of key terms and a 

link to further information to understand NAMRS 

data. Unless otherwise noted, all data in this report 

is FFY 2018 NAMRS data. 

Exhibit 1.3: Comparison of Key Indicators Component and Case Component Data

Key Indicator Components Case Component

Description Summary statistics on all cases in 

fiscal year on 20 data elements

Case-level information on all cases 

in fiscal year on 54 data elements

Information 

Categories

Summary information on:

• Investigations

• Clients/Victims

• Perpetrators

• Maltreatment type

• Client-Perpetrator relationship

Detailed information on:

• Investigations

• Clients/Victims

• Perpetrators

• Maltreatment type

• Client-Perpetrator relationship

Submission

Process

• Match program’s data definitions and 

values to NAMRS

• Create data reports

• Enter data on NAMRS website

• Validation and approval

Match program’s data definitions and 

values to NAMRS

Extract data into XML file

8.Upload data to NAMRS website

9. Validation and approval

Reviewers should always take into 

consideration the notes on each graph to 

understand key aspects and limitations of 

the data, including:

• The number of records, investigations, or clients;

• Whether the counts are duplicated or 

unduplicated; 

• How many states submitted data for particular 

elements;

• The percent of records that were Unknown;* and 

• Other explanatory information, as provided. 

Notes: *Unknown values are reported when there are no data because 1) APS staff were unable to determine the correct value 

or 2) did not collect the information. The percentages displayed in the exhibits are calculated using Unknown data. States that 

submitted all Unknown values are excluded from the analysis. 
Adult Maltreatment Data Report 2018 Chapter 2 | 7

What do we know about reports of maltreatment to APS? 

Notes: The number of reports data is based on submission by 48 states. 

Sources of reported maltreatment data is based on submission by 24 

states for 379,042 report sources. There can be multiple report sources 

for each investigation; Unknown report sources is 9.5 percent. 

Exhibit 2.1: Total Maltreatment Reports

Exhibit 2.2: Source of Reported Maltreatment for APS Clients

Notes: Sources of reported maltreatment data is based on submission by 24 states for 379,042 report sources. There can be 

multiple report sources for each investigation; Unknown report sources is 9.9 percent. 

Chapter 2: Reports and Investigations of Maltreatment

The first step in an APS case is to receive reports of 

allegations of maltreatment through a pre-screening 

or intake process. As shown in Exhibit 2.1, in FFY 

2018, APS programs received 1.7 million reports 

and accepted 45 percent (791,161) for investigation. 

These reports usually include information about the 

alleged victim, alleged perpetrator, location where 

the maltreatment occurred, identification of collateral 

contacts (e.g., family, friends, service providers), and 

the type(s) of alleged maltreatment. NAMRS data 

indicate that: 

• Three-quarters of states receive reports 

through a statewide hotline alone or in 

combination with a local hotline; one-quarter 

of states receive intakes only at the local level 

(see Appendix E). 

• The number of intakes vary little from month to 

month and is slightly higher in the summer and 

January (see Appendix F). 

• The location of reported maltreatment is 

usually in the community and not a provider 

location (see Appendix G).

Once the APS program receives a report of 

maltreatment, it has to determine whether to accept 

it for investigation. To determine whether to accept 

the report, intake staff will consider whether the 

alleged victim appears to meet the criteria for the 

population served by the APS program and other 

program criteria. If the report is not consistent 

with these criteria, it may be referred to a more 

appropriate agency or information may be provided 

to the reporter to assist the alleged victim.

State APS statutes usually mandate who is required 

to report allegations of maltreatment. Fifteen states 

have universal reporting laws, meaning everyone is 

a mandated reporter. Other states mandate specific 

categories of professionals. As shown in Exhibit 

2.2, professionals make over half of the reports and 

relatives make ten percent of reports.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 2 | 8

Chapter 2: Reports and Investigations of Maltreatment

How many investigations did APS programs conduct and

how many clients and victims were there in those investigations? 

After accepting a report of maltreatment, APS 

programs conduct an investigation. An APS 

investigation involves an assessment of the needs 

of the client and the determination of the validity 

of allegations against perpetrators. Even if an 

allegation is not substantiated, the caseworker may 

work with the client to find resources to address 

any unmet needs. 

In FFY 2018, APS programs conducted 760,953 

investigations involving 775,023 clients. (The total 

number of clients exceeds the total number of 

investigations because a client may be the subject of 

more than one investigation.)

APS investigations determine the finding (or 

disposition) for each allegation. If one or more of 

the allegations is found to be valid based on state 

law and policy, then the case is considered to be 

“substantiated.” For many states, a substantiated 

finding means that APS can provide ongoing services 

to address root causes of the maltreatment and take 

appropriate remedy against perpetrators. The APS 

program assesses each allegation for each client 

in an investigation. In NAMRS, a client with one 

substantiated allegations is identified as a victim. In 

FFY 2018, there were 243,375 victims substantiated 

by APS programs and overall 31.4 percent of clients 

were found to be victims.

NAMRS also collects data from case component 

states on all types of dispositions. Other potential 

findings are unsubstantiated, inconclusive, and 

other. Appendix H provides a chart that defines 

each type of finding, the percent of clients for each 

type of finding, and a chart with the differences 

in substantiation rates across maltreatment types. 

Allegations of financial exploitation, sexual abuse, 

and physical abuse have higher inconclusive rates 

than other types of maltreatment.

Notes: The total number of investigations is based on submission by 51 states. It is less than the total number of reports accepted (discussed on 

page 7) because a report accepted at intake may get screened out for various reasons by investigation staff and not counted as an investigation. 

The total number of 2018 clients is based on submission by 51 states.

 243,375 

Victims substantiated

by APS programs in 2018

31.4%

Clients substantiated 

as victims

 760,953 

Investigations conducted 

by APS programs

 775,023 

Clients involved in APS 

program investigations
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 2 | 9

Chapter 2: Reports and Investigations of Maltreatment

The length of an APS case depends on many factors, 

including the nature of the allegations, cooperation 

of the alleged perpetrator and others involved, 

APS’s ability to gather evidence, and staffing/

workload levels. Most APS programs report in 

NAMRS the maximum length of time established in 

policy for the investigation phase of a case.

Average Length of Time (Across States)

Case Initiation: 1.4 days

Investigation Duration: 50.4 days

Total Case Duration: 63.5 days

Averaging this policy timeframe across the states 

indicates that the average length allowed for an 

investigation is 47 days. The three different time 

periods usually measured in an APS case are: 

• Investigation Initiation: Time from receipt of 

the report until the start of the investigation. 

Most APS investigations are initiated within 

one day and almost all of them are initiated 

within seven days.

• Investigation Duration: Time period from 

the start of the investigation to determining 

the findings (disposition date). Almost twothirds of APS cases have an investigation 

duration between 15 and 90 days. The largest 

percentage of cases average is between 31 and 

60 days.

• Total Case Duration: Time period from the 

start of the investigation until the case is closed 

(including provision of services). Approximately 

half of APS cases are closed between 15 and 60 

days. The largest percentage of cases average 

between 31 and 60 days.

Notes: Investigation initiation is based on submission by 30 states for 415,387 investigations; Unknown is 3.2 percent. Investigation duration is 

based on submission by 26 states for 337,382 investigations; Unknown is 7.6 percent. Total case duration is based on submission by 31 states for 

429,209 investigations; Unknown is 2.8 percent. 

Exhibit 2.3: Length of Time for Investigation Initiation

Exhibit 2.4: Length of Time for Investigation Duration

Exhibit 2.5: Length of Time for Case Duration

How long does it take to investigate a case?
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 2 | 10

Chapter 2: Reports and Investigations of Maltreatment

What are the case closure reasons for APS cases? 

An APS case can be closed for a number of reasons. A 

case typically consists of an investigation and, if 

needed, services to address the maltreatment. A case 

can be closed after the investigation or after provision 

of services. Some programs include services as part of 

the APS case and some do not. One of the key aspects 

of APS casework is respect for the rights of the alleged 

victim. Depending on the state, the client can refuse to 

cooperate with an investigation or can refuse services, 

both of which can be reasons to close a case. A client 

death will often result in case closure, especially when 

a perpetrator is not involved. 

Almost half of APS cases in FFY 2018 have a completed 

investigation with no services provided and almost 

one-third are closed after conclusion of services. The 

remaining cases were closed because of lack of client 

cooperation, death, or other reasons. Protective 

services are provided more often in cases of selfneglect than in all other types of types of maltreatment 

(see Appendix I for data). 

28% of APS cases are closed 

after provision of services.

Notes: Case closure reason data is based on submission by 27 states for 391,200 clients; Unknown is two percent. Client decision includes when an 

investigation is unable to be completed due refusal of client or the case was closed due to client decision not to continue.

Exhibit 2.6: Case Closure Reasons for APS Clients
Adult Maltreatment Data Report 2018 Chapter 3 | 11

What is the age of APS clients and victims?

Notes: The victim-client age comparison is based on submission by 45 states and 179,582 victims and submission by 30 states and 420,216 clients. 

Exhibit 3.1: APS Victims by Age Group

Chapter 3: Clients, Victims, and Perpetrators

APS programs define the population they serve 

according to age and disability or vulnerability. As 

shown in Appendix A, all APS programs serve older 

adults and 15 programs do not require the older 

adult to have a disability or vulnerability. While 

almost all programs also serve younger adults, they 

all require younger individuals to have a disability or 

vulnerability, which reduces the size of the younger 

adult population eligible for APS. In addition, many 

of the risk factors for adult maltreatment, such as 

social isolation or declining health or cognitive 

status, are more present in older adult populations. 

As a result, APS programs serve more older adults 

than younger adults.

The age distribution in NAMRS data for APS clients 

and victims shows that 70 percent of them are age 

60 or older. Overall, victims are slightly older than 

clients. Compared to the overall victim population, 

victims of physical abuse and sexual abuse are 

younger, while victims of exploitation are older (see 

Appendix I for data).
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 3 | 12

Chapter 3: Clients, Victims, and Perpetrators

What is the gender, race, and ethnicity of APS clients and victims?

Notes: Gender client data is based on submission by 29 states for 

417,385 clients; Unknown is 2.2 percent. Gender victim data is based on 

submission 44 states for 179,195 victims; Unknown is 2 percent.

Exhibit 3.2: APS Clients and

Victims by Gender

Notes: Race victim data is based on submission by 41 states for 166,415 victims; Unknown is 15.7 percent. Ethnicity victim data is based on 

submission by 36 states for 149,015 victims; Unknown is 31.7 percent. Race client data is based on submission by 29 states for 419,389 clients; 

Unknown is 22.3 percent. Ethnicity client data is based on submission by 24 states for 385,967 clients; Unknown is 40.5 percent.

Exhibit 3.3: APS Clients and Victims by Race and Ethnicity

Women are a higher percentage than men of APS 

clients and victims. APS investigates allegations of 

domestic violence, including physical, sexual, and 

emotional abuse. Overall, there is very little difference 

between the percentages of clients and victims by 

gender. Comparing gender across allegation types, 

NAMRS data indicates that victims of physical, 

emotional, and sexual abuse are more likely to be 

women than men (see Appendix I for data).

While APS programs serve all individuals regardless of 

race or ethnicity, the majority of APS clients are white 

and non-Hispanic. APS programs do not collect race 

and ethnicity information as consistently as other 

demographic information, particularly in cases that are 

not substantiated. Since the Unknown percentage of 

clients is considerably higher than the percentage of 

victims, victim data is a more accurate reflection of race 

and ethnicity of the APS population. There are no notable 

differences in race and ethnicity of clients victims across 

maltreatment types (see Appendix I for data). 
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 3 | 13

Chapter 3: Clients, Victims, and Perpetrators

What types of disabilities do APS clients and victims have?

Understanding a client’sdisability statusis an important 

part of an APS investigation. It is used to determine if 

they meet the eligibility criteria for a victim’s disability 

and is also an important part of the assessment to 

develop a plan to meet their service needs. The 

National Adult Maltreatment Reporting System defines 

a disability asthe “client’s[victim’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. A client [victim] can have 

multiple disabilities.” Almost all APS victims have one 

or more disabilities, even in states which do not require 

disability for program eligibility. A slightly higher 

percentage of victims than clients have a disability. 

APS victims often have more than one type of 

disability. Ambulatory difficulties are the most 

frequent type of 

disability for APS victims and cognitive impairment is 

the most frequent type for clients. One consequence 

of the functional limitations caused by disabilities 

is that an individual’s ability to live independently 

and/or care for themselves may be impaired, which 

is a critical factor that must be addressed in the 

service plan. Ambulatory difficulties are higher in 

self-neglect victims than in victims of other types of 

maltreatment (see Appendix I for data). 

6.9 percent of APS clients are assessed 

and determined not to have a disability.

Notes: Disability data for victims is based on submission by 17 states for 83,900 victims; the percent Unknown is 41.3 percent. Disability data for 

clients is based on submission by 18 states for 270,408 clients; Unknown is 35.0 percent. A client or victim can have more than one type of disability. 

Disability Type Definition Percent of Clients Percent of Victims

Cognitive difficulty

Because of a physical, mental, or emotional 

problem, having difficulty remembering, 

concentrating, or making decisions.

Ambulatory 

difficulty

Having serious difficulty walking or climbing 

stairs.

Independent living 

difficulty

Because of a physical, mental, or emotional 

problem, having difficulty doing errands 

alone such as visiting a doctor’s office or 

shopping.

Self-care difficulty Having difficulty bathing or dressing.

Other Disabilities other than those specified 

in the categorizations provided.

None Assessed, but no disability determined.

Communication 

difficulty

Because of a physical, mental, or emotional 

problem, having difficulty with speech or 

language.

Vision difficulty Blind or having serious difficulty seeing, 

even when wearing glasses.

Hearing difficulty Deaf or having serious difficulty hearing.

29.1% 20.4%

25.0% 35.2%

20.8% 12.2%

11.9% 10.7%

6.9% 4.7%

6.9% 2.3%

5.0% 3.8%

3.3% 3.9%

3.1% 3.6%

Exhibit 3.4: APS Clients and Victims by Type of Disability
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 3 | 14

Chapter 3: Clients, Victims, and Perpetrators

How many APS clients and victims had previous reports to APS?

Notes: In NAMRS the definition of recurrence of a previous report is: “The indication that the agency has information that the client was the subject 

of a previous report.” Previous report victim data is based on submission by 15 states for 95,647 victims; Unknown is 0.7 percent. Previous report 

client data is based on submission by 16 states for 330,693 clients; Unknown is 4.2 percent.

Exhibit 3.6: Maltreatment Types by All Victims and Victims with a Previous Report

Exhibit 3.5: Percent of APS Clients and 

Victims with a Previous APS Report

There are several reasons why maltreatment of an 

APS victim may re-occur. While APS programs may 

address emergency needs or even the root causes of 

the maltreatment, the at-risk nature of the population 

and the frequent lack of sufficient services available 

to the client may result in maltreatment re-occurring. 

APS victims are also at risk from changes to their 

financial, mental, or physical conditions, to their 

informal or formal support systems, or in their living 

situations. More victims than clients had previous 

reports of maltreatment. Some causes of recurrence, 

 45% 

APS victims that had a previous 

report of maltreatment

such as poor health or poverty, are more likely to 

affect victims of self-neglect than other maltreatment 

types. Consequently, self-neglect victims experience 

recurrence at higher rates than victims of other types 

of maltreatment (see Appendix I for data).
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 3 | 15

Chapter 3: Clients, Victims, and Perpetrators

What are the living settings of APS clients?

Most APS clients live in the community at the start 

and at the close of an APS case. Comparing the living 

situations of the same set of clients (from the small 

sample of states that submit this data) at the start 

and close of an APS case reveals changes for a small 

percent of clients. The change in the living setting 

may be the result of the maltreatment. For example, 

an individual no longer able to care for themselves 

physically may have been reported for self-neglect 

and will require an alternative living environment to 

meet their care needs.

The number of APS clients that live in their residence, 

or that of a relative or caregiver, decreased from the 

start to the end of APS case and the number living 

in residential settings increased. One concern often 

expressed about APS interventions is that clients are 

inappropriately placed in residential care facilities. 

This data indicates only a small increase in placements 

between the start and close of an APS case.

Living Setting Number of 

Clients at Start

Percent of 

Clients at 

Start

Number of 

Clients at 

Close

Percent of 

Clients at 

Close

Residence of client, relative, or caregiver 79,588 69.6% 73,784 64.5%

Nursing home (non-specific) 3,602 3.2% 5,043 4.4%

Other setting 3,885 3.4% 9,413 8.2%

Residential care community (non-specific) 1,486 1.3% 1,778 1.6%

Licensed residential care community 1,416 1.2% 3,039 2.7%

Licensed nursing home 687 0.6% 1,966 1.7%

Non-licensed residential care community 47 0.04% 78 0.1%

Non-licensed nursing home 1 0.001% 2 0.002%

Unknown 23,610 20.7% 19,219 16.8%

Notes: Based on submission by 10 states of 114,322 clients.

Exhibit 3.7: Client Living Settings at the Start and Close of an APS Case
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Chapter 3 | 16

Chapter 3: Clients, Victims, and Perpetrators

What are the demographic characteristics of perpetrators?

A perpetrator in an APS case is defined as “each 

person determined to be responsible for one or more 

maltreatments with a disposition of substantiated.” 

While NAMRS collects several data elements on 

perpetrators, most states do not submit these 

data elements because they do not collect data on 

perpetrators. Many states will count the victim in a 

self-neglect case as a perpetrator, sometimes called 

a “self-perpetrator.” The NAMRS data reported here 

does not include individuals identified in self-neglect 

cases as perpetrators. 

As reported to NAMRS, perpetrators are younger 

than victims. While most victims are age 60 and older, 

perpetrators tend to be middle age, with the highest 

percentage being between 50-59 and the second 

highest group being 40-49. The only notable difference 

across maltreatment types is that sexual abuse 

perpetrators are younger (see Appendix I for data).

Perpetrators are more likely to be women than men. 

Based on data reported to NAMRS, 45 percent of 

perpetrators are women and 39 percent are men 

(gender was unknown in the remaining cases.) There are 

significant differences across gender and maltreatment 

types. Compared to all perpetrators, the percentage of 

perpetrators who are men is much higher in cases of 

abuse (physical, sexual, and emotional) and is lower in 

cases of neglect (see Appendix I for data).

Notes: Age is based on submission by 19 states for 27,872 perpetrators; Unknown is 26.8 percent. Many states will count the victim in a self-neglect 

case as a perpetrator, sometimes called a “self-perpetrator.” While NAMRS collects this information based on how the state defines a perpetrator,

it is excluded from the analysis in this report. Perpetrator gender is based on submission by 25 states for 41,163 perpetrators; Unknown is 16.0%.

Exhibit 3.8: Perpetrators by Age Group
Adult Maltreatment Data Report 2018 Conclusion | 17

Conclusion 

What is the role of data in improving APS? 

The National Adult Maltreatment Reporting System 

(NAMRS) has been collecting data from APS programs 

for three years. Other efforts to improve the APS 

system include the National Voluntary Consensus 

Guidelines for APS System, the current national 

evaluation of state systems, and other research 

efforts. When combined with the insights from 

NAMRS, these efforts provide new knowledge for 

states and policy makers to develop new strategies to 

improve APS systems. These combined efforts are 

building new paths to improve APS programs.

NAMRS is still a very young system. Many aspects of 

APS practice and operation vary significantly across 

the states, including the sophistication of data/case 

management systems and processes for reporting 

data. While the number of states able to submit 

Case Component data has increased every year, 

inconsistency in data quality reduces opportunities 

to use client, victim, and perpetrator data to improve 

prevention and intervention strategies.

To improve data submissions, states need to collect 

data more uniformly at the local level and submit 

more data at the national level. Through the 

Administration for Community Living (ACL) grants 

and state funding, APS programs continue to invest 

in improved data collection systems, which will result 

in more and better quality NAMRS data. However, 

collecting the data is only a first step to program 

improvement. States must also be able to extract, 

analyze, and submit the data to NAMRS. Some states 

are unable to submit all the data they collect because 

they lack resources to extract and submit the data. 

The result is an incomplete picture at the national 

level and limits on the ways the data can be used. 

To improve data quality, review and analysis of 

NAMRS data needs to move beyond generating 

summary table comparisons and high-level analysis 

to more in-depth and cross-cutting analyses. With 

multiple years of data, analysis can be done over 

time and with more insight into what the data 

means. This type of analysis will shed more light 

on those who experience abuse, neglect, and 

exploitation and interact with APS. 

This new knowledge will lead to improved 

intervention, prevention, and practice. Improving 

APS programs will ultimately improve the quality of 

life of all adults across the country.

Continued efforts to improve data 

collection, submission, and analysis 

will result in opportunities to improve 

APS programs. 
Adult Maltreatment Data Report 2018 Appendix | 18

Appendix A

Understanding APS Populations 

Nationwide, the population APS agencies serve can 

be grouped into four categories:

• Elderly only (age 60): 3 states,

• Elderly with disability (age 60 or 65 with a 

disability): 2 states,

• Adults with disability and all elderly (age 18 to 

59 or 64 with a disability): 12 states, and

• Adults with disability (age 18 and older with 

disability): 35 states.

In addition to the demographic criteria, the 

population APS programs serve also depends on 

state policy regarding the location, or setting, of 

the alleged maltreatment and the relationship 

between the alleged victim and the perpetrator. 

For example, some APS agencies do not investigate 

allegations in residential care communities and/

Exhibit A.1: Eligible Populations by State

Age and disability are the major 

demographic factors that determine 

the population served by each state.

or nursing facilities. Many APS programs require a 

non-professional or person in a trusted/or ongoing 

relationship between the alleged victim and the 

perpetrator. This means they would not investigate 

certain types of phone scams or potential 

exploitation in a business transaction.

When the APS agencies do not have jurisdiction, other 

state programs (regulatory/licensing programs or the 

Attorney General’s office) or law enforcement may 

have responsibility for investigating and determining 

an appropriate response.
Adult Maltreatment Data Report 2018 Appendix | 19

Definitions of Maltreatment Types Percentage of States Investigating 

Each Type of Maltreatment

Neglect

The failure of a caregiver or fiduciary to provide the goods or 

services necessary to maintain the health or safety of a person. 

Includes acts of omission and of commission (including willful 

deprivation, etc.).

Physical Abuse The use of force or violence resulting in bodily injury, physical pain, 

or impairment. Excludes sexual abuse.

Self-Neglect

A person’s inability, due to physical or mental impairment or 

diminished capacity, to perform essential self-care tasks including 

obtaining essential food, clothing, shelter, and medical care; 

obtaining goods and services necessary to maintain physical 

health, mental health, or general safety; hoarding; or managing 

one’s own financial affairs.

Sexual Abuse Non-consensual sexual contact of any kind, including sexual 

contact with any person incapable of giving consent.

Financial 

Exploitation

The illegal or improper use of an individual’s funds, property, or 

assets for another person’s profit or advantage.

Emotional 

Abuse

The infliction of anguish, pain, or distress through verbal or 

nonverbal acts; this includes but is not limited to verbal assaults, 

insults, threats, intimidation, humiliation, and harassment.

Exploitation 

(non-specific)

The illegal or improper use of an individual or of an individual’s 

funds, property, or assets for another’s profit or advantage.

Abandonment

The desertion of a person by an individual who has assumed 

responsibility for providing care for that person, or by an individual 

with physical custody of another person.

Other 

Exploitation

The illegal or improper use of an individual for another person’s 

profit or advantage, including exploitation of person, servitude, etc.

Other A type of maltreatment not included in the categorizations 

provided.

Suspicious 

Death

An unexpected fatality or one in which circumstances or cause are 

medically or legally unexplained.

100%

98.1%

94.4%

92.6%

85.2%

81.5%

48.1%

42.6%

37.0%

35.2%

16.7%

What types of maltreatment does APS investigate? 

Each state has distinct laws and policies defining 

what types of adult maltreatment the APS program 

will investigate or assess. Nearly all states investigate 

allegations of neglect, physical abuse, self-neglect, sexual 

abuse, financial exploitation, and emotional abuse.

Some states investigate allegations of exploitation (nonspecific), abandonment, and other exploitation. Only a

small percentage of states investigate suspicious death. 

Additionally, definitions of maltreatment vary from 

state to state. For the purposes of submitting national 

data, states match their definitions to the equivalent 

categories listed below.

Appendix B
Adult Maltreatment Data Report 2018 Appendix | 20

What are key aspects of APS programs?

Notes: Source for assessment tool information is based on submission by 54 states. Source for FTEs is based on submission by 52 states on 

investigators and 50 on supervisors. Because of shared responsibilities, some states estimate the number of APS staff and county-level staffing. 

Budgeting information is not fully known to some state APS programs. Some supervisors may conduct investigations. Source for Standard of 

Evidence is based on submission by 53 states. States selected the category that best met their standard, even if the state category may use 

somewhat different terminology. 

Exhibit C.1: Standard of Evidence

Assessment Tools: APS programs use assessment tools 

for various casework purposes. Some tools are developed 

specifically for APS and some are general social work

tools. States may mandate use of tools statewide or 

leave the use to county or worker discretion. For this 

report, states indicate whether APS personnel use 

standard tools throughout the state for assessing risk or 

safety of clients.

78% 

States that use a common 

assessment tool statewide

Full-Time Equivalents (FTEs): Investigators and 

supervisors are key APS staff. Most APS programs

have staff dedicated only to APS; however, some

programs may share staff responsibilities with other

programs or processes. For example, a state may 

Appendix C

use a centralized intake program that accepts 

reports for APS as well as other programs or 

casework staff that may investigate both APS and

child protective services cases. In some programs, 

supervisors may also investigate allegations.

Standard of Evidence: States determine what 

standard of evidence is used for substantiating an 

allegation of maltreatment. Most state APS programs 

use a “preponderance of the evidence” standard 

which is usually defined to mean the greater weight

of the evidence.
Adult Maltreatment Data Report 2018 Appendix | 21

Exhibit D.1: Key Definitions of NAMRS Data Elements

Overview of NAMRS

NAMRS consists of three components: Agency 

Component, Key Indicators Component, and Case 

Component. All states provide Agency Component 

information and, if they are able, states then choose 

to provide either Key Indicators Component or Case 

Component data. Agency Component information 

consists of agency profile information, summary intake 

data, and investigation policy information. For states 

that can provide client-level data, the Case Component 

module allows for an upload of all client data on 

investigations and victims, clients, and perpetrators in 

an encrypted and de-identified file. If a state is unable to 

provide client-level data, the Key Indicators Component 

data module allows for submission of aggregated data 

on key statistics on the same case characteristics 

as Case Component. The Adult Protective Services 

Technical Assistance Resource Center liaisons review, 

validate, and approve data submissions. 

Definitions and code values of data elements and other 

information about NAMRS can be found online at the 

NAMRS website: https://namrs.acl.gov/. The chart 

below provides definitions of the key elements of the 

system.

Key Term Definition

Client A person who received an investigation regarding a report of alleged 

maltreatment

Victim A person who received an investigation and one or more of the alleged 

maltreatments were substantiated

Perpetrator A person associated with the substantiated maltreatment

Investigation Activities undertaken by APS to determine if allegations occurred and 

assess client needs with a case closure date during the reporting period

Maltreatment A type of abuse, neglect, or exploitation that is alleged to have occurred

Allegation Each reported occurrence and type of maltreatment associated with each 

client that is investigated

Case All activities and individuals related to the investigation of and response 

to an allegation of maltreatment.

Appendix D
Adult Maltreatment Data Report 2018 Appendix | 22

Appendix E

What types of intake models are used by APS?

The first step in an APS case is to receive reports of 

allegations of maltreatment. These reports usually 

include information about the alleged victim, alleged 

perpetrator, location where the maltreatment 

occurred, identification of collateral contacts (e.g.

family, friends, service providers), and the type(s) of 

alleged maltreatment. 

While APS programs receive reports of maltreatment 

in various ways, including in person and online, the 

majority of reports come in by phone to a hotline 

number at a call center. Depending on the state 

organization and structure, APS programs use, as 

defined in the nearby box, centralized, decentralized, 

or combination approaches to staffing hotlines.

Some hotlines are dedicated solely to APS and are 

staffed by APS professionals, while others might also 

handle reports for child protective or aging services. 

Reflecting the fact that most APS programs are state 

administered, most states conduct intake at the 

state level, using the centralized model and/or the 

combination model.

Notes: Hotline data based on submission by 55 states.

Exhibit E.1: Percentage of States by Type of Hotline Models

Three Types of Intake Models

10)Centralized (statewide): One hotline or call-in 

number providing a single entry point for reports

11)Decentralized (local): Hotlines or call-in numbers 

specific to county or region with multiple points

of entry dependent on location

12)Combination: Statewide number and local 

numbers
Adult Maltreatment Data Report 2018 Appendix | 23

When were maltreatment reports received? 

Notes: The average number of reports is based on submission by 48 states and 791,161 reports. Monthly data is based on submission by 31 states 

for 429,209 reports; Unknown is 2.8 percent.

Exhibit F.1: Monthly Distribution of Accepted Reports

Appendix F

The maltreatment of adults occurs on a daily basis 

throughout the United States. Many APS programs 

receive reports 24 hours a day. Nationally, the number 

of intakes varies very little from month to month and is 

slightly higher in the summer and January. 
Adult Maltreatment Data Report 2018 Appendix | 24

Appendix G

What was the setting of and who reported the alleged maltreatment?

2 National Adult Protective Services Technical Assistance Resource Center (APS TARC), Component 1: Review of State Adult Protective Services 

Policy: Final Report

The settings in which APS programs have authority to 

investigate allegations of maltreatment vary from state 

to state. All APS programs investigate allegations 

involving persons living in the community. According 

to the national APS evaluation, APS investigates 

allegations of maltreatment when they occur in at least 

some type of residential facility in 38 states.2  In 

other states, investigations of allegations of 

maltreatment are conducted by a regulatory/

licensing agency. Some APS programs have authority 

to investigate allegations involving the facility and 

its staff, while others only have authority to 

investigate allegations involving family members or 

maltreatment of residents not related to the facility 

staff or operations.

State APS statutes usually mandate who is required 

to report allegations of maltreatment. Fifteen states 

have universal reporting laws, meaning everyone 

is a mandated reporter, regardless of profession or 

relationship with the alleged victim. Other states 

mandate specific categories of professionals. 

Professionals make over half of the reports and 

relatives make ten percent of reports.

Location of reported maltreatment data indicates APS 

is predominantly a program investigating clients in 

community settings.

 Maltreatment Setting

Most maltreatment 

occurs in a residence.

Notes: Maltreatment setting data is based on submission by 15 states for 130,375 clients. The percentage of Unknown and empty records is 28.8 

percent. 

Exhibit G.1: Setting of Reported Maltreatment for APS Clients

Professionals 

make most 

APS reports.
Adult Maltreatment Data Report 2018 Appendix | 25

Notes: The total number of victims and percent of clients substantiated is based on submission by 50 states and excludes states that do not define 

substantiation consistent with NAMRS. The percentages for maltreatment dispositions are based on submission by 31 states for 572,136 clients.

Exhibit H.1: Maltreatment Disposition Types: 

Definitions and Percent of Clients by Type of Disposition

Maltreatment Disposition Percent of Clients

Type Definition

Unsubstantiated The finding that the allegation of maltreatment is 

not supported under state law and policy.

Substantiated The finding that the allegation of maltreatment is 

supported under state law and policy.

Other

Disposition not included in categorizations 

provided. Includes inappropriate

allegations that were investigated.

Inconclusive

The finding that there is insufficient information 

to either support or not support the allegation 

of maltreatment, but there is a reason to suspect 

maltreatment.

44.5%

25.2%

17.9%

12.4%

What are the disposition rates in APS cases?

Appendix H

In adult protective services (APS) cases, different 

types of maltreatment have different rates of 

substantiation. In general, allegations of self-neglect 

cases have much higher rates of substantiation 

than allegations involving perpetrators, such as 

physical abuse or financial exploitation. Allegations 

of financial exploitation, sexual abuse, and physical 

abuse have higher inconclusive rates than other types 

of maltreatment.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 26

Appendix H

Notes: The percent by disposition is based on submission by 31 states for 572,136 clients. A client can have more than one allegation in a case and 

is counted for each allegation.

Exhibit H.2: Percent of Clients by Disposition Type and by Maltreatment Type
Adult Maltreatment Data Report 2018 Appendix | 27

Table 1 – Substantiated Maltreatment Type by Case Closure Reason

This table displays the case closure reason for each substantiated maltreatment type.

Appendix I

Table 1 – Substantiated Maltreatment Type by Case Closure Reason

Case Closure ReasonAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseSelf-neglectOtherAll Victims

Investigation/Protective 

Services Completed 9.1% 31.9% 29.0% 37.8% 35.5% 36.0% 53.7% 12.3% 46.6%

Investigation Completed 58.3% 32.5% 45.0% 33.6% 39.8% 24.4% 27.4% 52.2% 32.0%

Other Reason 19.0% 19.3% 13.6% 16.5% 12.4% 15.4% 4.5% 14.7% 7.6%

Investigation unable to be 

completed due to refusal 

of client

1.5% 5.0% 2.9% 1.9% 3.0% 1.3% 4.6% 0.7% 4.0%

Protective services case 

closed due to client 

decision to not continue

0.1% 7.2% 4.7% 3.3% 5.8% 4.6% 3.2% 5.8% 3.5%

Investigation unable to be 

completed due to death of 

client during investigation

1.7% 0.7% 1.1% 2.5% 0.6% 0.1% 2.4% 2.2% 2.0%

Investigation unable to be 

completed (non-specific) 5.0% 0.4% 0.7% 0.4% 0.5% 0.6% 1.6% 3.9% 1.3%

Investigation/Services 

Incomplete/Client Death 0.9% 0.5% 0.7% 1.9% 0.6% 0.5% 1.0% 0.1% 0.9%

Investigation/Services 

Incomplete, Other 0.2% 0.2% 0.6% 0.7% 0.3% 0.5% 0.5% 3.1% 0.5%

Unknown 4.1% 2.2% 1.7% 1.4% 1.5% 16.8% 1.2% 5.2% 1.4%

TOTAL 820 7,748 15,181 12,232 7,729 877 82,250 3,565 117,046

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 28

Appendix I

Table 2 – Victim Maltreatment Type by Age Group

This tables displays the percentage of victim maltreatment types for each age group.

Table 2 – Victim Maltreatment Type by Age Group

Age GroupAbandonmentEmotional abuseExploitationNeglectOtherPhysical abuseSelf-neglectSexual abuseAll Victims

Age 18-29 9.4% 6.7% 3.2% 9.5% 7.9% 11.3% 2.6% 35.2% 4.2%

Age 30-39 9.4% 4.5% 2.6% 5.2% 5.3% 6.0% 2.8% 13.1% 3.4%

Age 40-49 10.4% 5.0% 2.6% 5.4% 6.9% 6.0% 4.9% 10.4% 4.8%

Age 50-59 17.0% 9.3% 6.3% 9.7% 14.4% 10.2% 12.9% 8.3% 11.6%

Age 60-69 22.7% 22.7% 20.2% 16.9% 19.5% 20.0% 25.6% 8.4% 23.5%

Age 70-74 8.8% 14.1% 14.5% 10.3% 10.6% 12.9% 14.7% 4.6% 13.9%

Age 75-84 12.0% 22.9% 28.7% 22.6% 21.4% 19.4% 23.3% 9.1% 23.4%

Age 85+ 8.5% 13.3% 19.7% 18.4% 13.1% 12.0% 11.9% 10.0% 13.5%

Unknown 2.0% 1.5% 2.3% 2.0% 0.9% 2.2% 1.4% 1.0% 1.6%

TOTAL 820 8,057 16,024 13,566 4,117 8,200 86,374 943 124,070

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 29

Appendix I

Table 3 – Victim Maltreatment by Gender Identity

This table displays percentage of substantiated maltreatment type by gender identity.

Table 3 – Victim Maltreatment by Gender Identity

Gender IdentityAbandonmentEmotional abuseExploitationNeglectOtherPhysical abuseSelf-neglectSexual abuseAll Victims

Male 49% 28% 39% 41% 40% 37% 43% 23% 41%

Female 51% 71% 59% 58% 59% 62% 56% 74% 58%

Transgender - - - - - - 0.003% - 0.002%

Unknown 0.1% 1% 2% 1% 1% 1% 1% 3% 1%

TOTAL 820 8,057 15,801 13,447 4,117 8,158 86,371 924 123,683

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 30

Appendix I

Table 4 – Victim Maltreatment Type by Race

This table displays percentage of victim race counts for each maltreatment type. 

Table 4 – Victim Maltreatment Type by Race

RaceAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseSelf-neglectOtherAll Victims

White 72.7% 71.1% 57.1% 62.5% 68.9% 60.7% 63.5% 67.4% 63.1%

Black 16.0% 14.3% 13.4% 18.5% 13.3% 14.4% 15.8% 9.1% 15.2%

OtherRace 0.7% 1.8% 2.7% 2.4% 2.3% 1.8% 1.9% 0.8% 2.0%

American Indian/

Alaska Native 

Non-Hispanic

0.9% 0.6% 0.8% 0.8% 0.8% 0.6% 0.9% 0.5% 0.8%

Asian 0.4% 0.7% 0.4% 0.5% 0.8% 1.1% 0.6% 0.1% 0.6%

Native Hawaiian 0.1% 0.2% 0.1% 0.1% 0.1% 0.2% 0.1% 0.1% 0.1%

Unknown 0.0% 9.5% 11.8% 26.1% 16.0% 14.5% 21.9% 17.8% 18.8%

National 820 8,035 15,972 13,543 8,194 943 86,374 4,115 123,984

Notes: States may select multiple values for each individual.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 31

Appendix I

Table 5 – Victim Maltreatment Type by Ethnicity

This table displays percentage of ethnicity counts across victim maltreatment types.

Table 5 – Victim Maltreatment Type by Ethnicity

EthnicityAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseSelf-neglectOtherAll Victims

Hispanic, 

Latino/a, or 

Spanish

1.9% 5.9% 3.2% 5.8% 8.9% 3.6% 13.9% 0.7% 11.2%

Not Hispanic, 

Latino/a, or 

Spanish

66.7% 53.3% 40.7% 49.3% 56.8% 52.4% 61.1% 52.2% 57.5%

Unknown 31.4% 40.8% 56.1% 44.9% 34.2% 44.0% 24.9% 47.1% 31.3%

All Victims 799 6,098 13,088 11,328 7,027 839 80,210 4,115 112,056

Source: Case Component

Notes: States may select multiple values for each individual.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 32

Appendix I

Table 6 – Victim Maltreatment Type by Race/Ethnicity

This table displays race/ethnicity percentage across victim maltreatment types.

Table 6 – Victim Maltreatment Type by Race/Ethnicity

Race/EthnicityAbandonmentEmotional abuseExploitationNeglectOtherPhysical abuseSelf-neglectSexual abuseAll Victims

White Non-Hispanic 71.0% 66.8% 54.9% 58.3% 66.7% 62.1% 52.4% 57.9% 54.4%

Black/African 

American NonHispanic16.0% 14.1% 13.2% 18.1% 9.1% 13.0% 15.5% 14.0% 15.0%

Hispanic/Latino 1.8% 4.4% 2.6% 4.9% 0.7% 7.7% 12.9% 3.2% 10.1%

American Indian/

Alaska Native NonHispanic0.6% 0.5% 0.7% 0.7% 0.4% 0.7% 0.8% 0.5% 0.7%

Other Non-Hispanic 0.7% 1.5% 2.1% 1.7% 0.8% 1.5% 1.5% 1.5% 1.5%

Asian Non-Hispanic 0.4% 0.6% 0.3% 0.5% 0.1% 0.7% 0.6% 1.0% 0.6%

Native Hawaiian/

Other Pacific 

Islander NonHispanic

0.0% 0.1% 0.1% 0.1% 0.0% 0.1% 0.1% 0.2% 0.1%

Multiple Races NonHispanic 0.1% 0.4% 0.4% 0.7% 0.1% 0.5% 0.6% 0.5% 0.5%

Unknown 9.4% 11.5% 25.6% 15.0% 22.1% 13.7% 15.7% 21.2% 17.1%

TOTAL 820 8,035 15,972 13,543 4,115 8,194 86,374 943 123,984

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 33

Appendix I

Table 7 – Victim Maltreatment Type by Disability

This table displays victim disability counts by maltreatment type. 

Table 7 – Victim Maltreatment Type by Disability

DisabilitiesAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseSelf-neglectOtherAll Victims

Cognitive 

Difficulty 54.6% 14.0% 26.2% 37.5% 22.1% 23.2% 18.3% 22.2% 20.4%

Ambulatory 

Difficulty 56.8% 11.0% 18.9% 27.5% 18.0% 6.6% 40.2% 0.3% 35.2%

Independent 

Living Difficulty 56.8% 7.1% 18.2% 22.3% 12.6% 8.0% 11.2% 0.3% 12.2%

Self-Care 

Difficulty 63.6% 7.1% 15.9% 18.5% 10.8% 3.2% 10.0% 1.7% 10.7%

Other Difficulty 6.8% 6.3% 10.5% 10.0% 7.3% 8.6% 3.1% 2.7% 4.7%

Communication 

Difficulty 18.2% 5.2% 5.4% 10.0% 6.5% 3.0% 2.9% 0.0% 3.8%

Hearing 

Difficulty 2.3% 11.9% 8.7% 9.6% 6.9% 5.5% 2.0% 0.2% 3.6%

Vision Difficulty 0.0% 8.1% 6.0% 8.6% 4.8% 3.0% 3.1% 0.0% 3.9%

None 0.0% 8.2% 8.1% 2.0% 6.2% 5.0% 1.2% 0.0% 2.3%

Unknown 11.4% 46.5% 34.6% 29.6% 44.0% 56.1% 42.6% 75.3% 41.3%

TOTAL 44 4,403 8,334 8,043 4,731 440 65,349 600 83,900

Source: Case Component

Notes: States may select multiple disabilities for each individual.
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 34

Appendix I

Table 8 – Victim Maltreatment Type by Previous Report

This table displays percentage of previous victim report by each maltreatment type.

Table 8 – Victim Maltreatment Type by Previous Report

Previous ReportAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseSelf-neglectOther TypeAll Victims

Yes 60.1% 32.8% 34.5% 40.4% 37.6% 37.5% 47.8% 53.0% 44.9%

No 39.9% 67.2% 62.7% 59.0% 60.6% 62.5% 51.9% 47.0% 54.5%

Unknown 0.0% 0.0% 2.8% 0.6% 1.8% 0.0% 0.3% 0.0% 0.7%

TOTAL 776 6,481 10,101 9,779 6,547 594 69,419 2,370 95,647

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 35

Appendix I

Table 9 – Substantiated Maltreatment Type by Perpetrator Age Group

This table displays perpetrator age group percentage by maltreatment type. 

Table 9 – Maltreatment Type by Perpetrator Age Group

Age GroupAbandonmentEmotional abuseExploitationNeglectPhysical abuseSexual abuseOtherAll Substantiated Perpetrators

Age 17 or 

Younger 0% 3.3% 3.8% 6.0% 6.1% 8.9% 4.6% 4.9%

Age 18-29 6.6% 9.6% 7.7% 6.3% 12.9% 13.9% 8.6% 8.5%

Age 30-39 9.4% 12.9% 12.8% 9.6% 13.4% 7.0% 7.0% 11.2%

Age 40-49 13.3% 15.1% 14.5% 13.4% 13.9% 15.2% 7.9% 13.1%

Age 50-59 18.6% 16.2% 13.5% 17.2% 14.6% 14.2% 12.9% 14.9%

Age 60-69 21.0% 9.5% 6.4% 11.5% 9.0% 8.2% 15.6% 9.8%

Age 70-74 6.5% 3.3% 1.2% 3.6% 3.6% 3.8% 8.0% 3.4%

Age 75-84 7.3% 3.7% 1.0% 5.0% 5.1% 4.1% 15.7% 4.8%

Age 85+ 2.3% 1.4% 1.0% 2.4% 2.2% 0.9% 9.0% 2.6%

Unknown 14.9% 24.9% 38.1% 25.0% 19.3% 23.7% 10.7% 26.8%

TOTAL 724 4,918 10,375 8,142 5,151 316 2,973 27,872

Source: Case Component
Adult Maltreatment Data Report 2018 Adult Maltreatment Data Report 2018 Appendix | 36

Appendix I

Table 10 – Maltreatment Type by Perpetrator Gender Identity

This table displays percentage of perpetrator gender identity for each maltreatment type.

Table 10 – Maltreatment Type by Perpetrator Gender Identity

Gender AbandonmentEmotional abuseExploitationNeglectOtherPhysical abuseSexual abuseAll Substantiated Perpetrators

Male 42.0% 49.5% 34.3% 35.3% 33.7% 49.3% 67.2% 39.3%

Female 51.2% 38.5% 46.0% 49.6% 58.5% 37.5% 10.7% 44.7%

Transgender 0% 0% 0% 0% 0% 0% 0% 0%

Unknown 6.9% 12.0% 19.7% 15.0% 7.8% 13.2% 22.1% 16.0%

TOTAL 815 7,923 14,814 13,280 2,997 7,940 738 41,163

Source: Case Component