NAMRS FFY 2016

Report 3: Case Component

July 23, 2018
Suggested Citation:

Acker, D., Aurelien, G., Beatrice, M., Capehart, A., Gassoumis, Z., Ph.D., Gervais-Voss, P., 

Greene, M., Phillippi, M. (2018). NAMRS FFY2016 Report 3: Case Component. Administration 

for Community Living, U.S. Department of Health and Human Services: Washington, D.C.

Disclaimer:

This project was funded by the Administration for Community Living under contract number 

HHS-P233201500042I to WRMA, Inc. The statements contained in this publication do not 

necessarily reflect the views or policies of the Department of Health and Human Services and 

Administration for Community Living.

Acknowledgements

The Administration for Community Living gratefully acknowledges the voluntary submission of 

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

Columbia, and Territories. Without the support of the Adult Protective Services staff, supervisors, 

and program administrators’ collection of data and reporting into state systems, it would have been 

impossible to have achieved the historical, first submission of data (FFY 2016) into the National 

Adult Maltreatment Reporting System.

In addition, we applaud the work of the:

 Elder Justice Coordinating Council in making the collection of data regarding adult 

maltreatment a priority issue;

 Department of Health and Human Services’ Assistant Secretary for Planning and 

Evaluation for support of the initial development and piloting of NAMRS; and

 Numerous experts, university faculty, medical researchers, and national organizations 

representing the field of adult maltreatment who provided guidance on NAMRS 

development.
Contents

CONTENTS.................................................................................................................................... i

EXECUTIVE SUMMARY ........................................................................................................III

CASE COMPONENT DATA ...................................................................................................... 1

STATE SUBMISSION RATES ........................................................................................................ 2

CASE COMPONENT – INVESTIGATIONS...................................................................................... 3

IN-1 Investigation Records Submission ................................................................................. 3

IN-2a Investigations – Report Source Among Investigation.................................................. 3

IN-2b Investigations – Multiple Report Sources .................................................................... 5

IN-2c Investigations – Report Source by Substantiated Maltreatment Type ......................... 5

IN-3a Investigations – Duration.............................................................................................. 7

IN-3b Investigations – Duration by Substantiated Maltreatment Type .................................. 8

CASE COMPONENT – CLIENTS ................................................................................................... 9

CL-1 Client Record Submission ............................................................................................. 9

CL-2 Clients – Maltreatment Setting.................................................................................... 10

CL-3a Clients – Case Closure Reason .................................................................................. 10

CL-3b Victims – Case Closure Reasons by Substantiated Maltreatment Type.................... 12

CL-4a Clients – Age Group .................................................................................................. 12

CL-4b Victims – Age Group by Substantiated Maltreatment Type ..................................... 13

CL-5a Clients – Gender Identity........................................................................................... 14

CL-5b Clients – Gender Identity by Substantiated Maltreatment Type ............................... 15

Clients – Sexual Orientation ................................................................................................. 16

CL-6a Clients – Race ............................................................................................................ 16

CL-6b Clients – Multiple Races ........................................................................................... 17

CL-7 Clients – Ethnicity ....................................................................................................... 17

CL-8a Clients – Race/Ethnicity ............................................................................................ 18

CL-8b Victims – Race/Ethnicity by Substantiated Maltreatment Type ............................... 19

CL-9 Clients – Primary Language ........................................................................................ 21

CL-10 Clients – Schooling Level ......................................................................................... 22

CL-11a Clients – Marital Status ........................................................................................... 22

CL-11b Victims – Marital Status by Substantiated Maltreatment Type............................... 23

CL-12 Clients – Employment Status .................................................................................... 24

CL-13 Clients – Income Level.............................................................................................. 25

CL-14a Clients – Benefits..................................................................................................... 25

CL-14b Clients – Multiple Benefits...................................................................................... 26

CL-15 Clients – Veteran Status ............................................................................................ 27

CL-16a Clients – Disabilities................................................................................................ 27

CL-16b Clients – Multiple Disabilities................................................................................. 28

CL-16c Victims – Disabilities by Substantiated Maltreatment Type ................................... 29

CL-17 Clients – ADL and IADL Score ................................................................................ 29

CL-18a Clients – Behavioral Health Conditions .................................................................. 31

CL-18b Clients – Multiple Behavioral Health Conditions................................................... 32
CL-19 Clients – Living Settings at Start and Close .............................................................. 32

CL-20a Clients – Substitute Decision Makers at Start and Close......................................... 33

CL-20b Clients – Multiple Substitute Decision Makers at Start and Close ......................... 34

CL-21a Clients – Services at Start........................................................................................ 34

CL-21b Clients – Multiple Services at Start ......................................................................... 36

CL-22a Clients – Services Provided by APS........................................................................ 36

CL-22b Clients – Multiple Services Provided by APS......................................................... 37

CL-23a Clients – Services Referred ..................................................................................... 38

CL-23b Clients – Multiple Services Referred ...................................................................... 39

CL-24a Clients – Services at Close ...................................................................................... 40

CL-24b Clients – Multiple Services at Close ....................................................................... 41

CL-25a Clients – Interagency Coordination ......................................................................... 41

CL-25b Clients – Multiple Interagency Coordination .......................................................... 42

CL-26a Clients – Previous Reports....................................................................................... 42

CL-26b Victims – Previous Reports by Substantiated Maltreatment Type.......................... 43

CASE COMPONENT – MALTREATMENT ALLEGATIONS .......................................................... 44

MA-1 Maltreatment Allegation Record Submission ............................................................ 44

MA-2 Maltreatment Allegation – Types and Dispositions................................................... 44

MA-3 Maltreatment Allegation – Multiple Substantiation................................................... 45

CASE COMPONENT – PERPETRATORS ..................................................................................... 46

PR-1 Perpetrator Record Submission ................................................................................... 46

PR-2a Perpetrators – Age Group .......................................................................................... 46

PR-2b Perpetrators – Age Group by Substantiated Maltreatment Type............................... 47

PR-3a Perpetrators – Gender Identity................................................................................... 48

PR-3b Perpetrators – Gender Identity by Substantiated Maltreatment Type........................ 49

PR-4a Perpetrators – Race .................................................................................................... 49

PR-4b Perpetrators – Multiple Races.................................................................................... 50

PR-5 Perpetrators – Ethnicity ............................................................................................... 50

PR-6a Perpetrators – Race/Ethnicity .................................................................................... 51

PR-6b Perpetrators– Race/Ethnicity by Substantiated Maltreatment Type .......................... 52

PR-7a Perpetrators – Disabilities.......................................................................................... 53

PR-7b Perpetrators – Multiple Disabilities........................................................................... 53

PR-8a Perpetrators– Behavioral Health Conditions.............................................................. 54

PR-8b Perpetrators– Multiple Behavioral Health Conditions .............................................. 55

CASE COMPONENT – CLIENT-PERPETRATOR RELATIONSHIPS.............................................. 56

CPR-1 Client-Perpetrator Relationship Record Submission ................................................ 56

CPR-2 Client-Perpetrator Relationships – Cohabitation ...................................................... 56

CPR-3 Client-Perpetrator Relationships – Kinship Relationship ......................................... 57

CPR-4 Client-Perpetrator Relationships – Perpetrator Association at Start......................... 58

CPR-5 Client-Perpetrator Relationships – Perpetrator Association at Close ....................... 59

Client-Perpetrator Relationships – Perpetrator Substitute Decision Maker ......................... 60

CPR-6a Client-Perpetrator Relationships – Perpetrator Legal Remedy Recommendations 60

CPR-6b Client-Perpetrator Relationships – Multiple Perpetrator Legal Remedy ................ 61
iii

Executive Summary

The statistics in this report are based on data submitted to NAMRS, which is a voluntary reporting 

system that was developed by the U.S. Department of Health and Human Services, Administration 

for Community Living. In FFY 2016, 54 APS reporting jurisdictions volunteered to participate 

by providing information and data. For NAMRS, a reporting jurisdiction is the officially 

designated APS office in the state, territory, or district.

The Agency Component report offers an overview of the policies and practices of state APS 

agencies. In addition to submitting the data elements highlighted in this report, states provided 

narratives regarding statutes, policies and procedures, investigative practices, data systems, intake 

processes, staffing, training, and client assessments. Narrative information such as state statutes, 

policies, training, etc. will be used in developing future discussion papers.

Additional information gleaned from the initial year of NAMRS data submissions can be accessed 

in the following reports:

 NAMRS FY 2016 Background Report: This report discusses the development of the 

NAMRS data system, provides an overview of the data elements and the data submission 

process, and discusses the known limitations and future directions of NAMRS.

 NAMRS FY 2016 Report 1.2: Agency Component: This report provides highlights of 

APS agency profile information and investigation data submitted for FFY 2016.

 NAMRS FY 2016 Report 2: Key Indicators: This report consists of aggregated data on 

key statistics of investigations and victims, clients, and perpetrators provided by states that 

are unable to provide case-level data.

A final note on limitations of the FFY 2016 data reports. In this first year of a new, national 

reporting system, care was taken to explain how many states were able to submit information; the 

percentage of individual data elements provided; and to describe limitations discovered when 

reviewing data. For FY 2016, no state could provide all Case Component, nor all Key Indicators, 

data elements, and no two states reported on all of the same data elements. Furthermore, as 

NAMRS was developed to allow maximum flexibility for states to be able to report data in a way 

that did not increase burden for the states’ participation, data contained in the exhibit tables will 

not always total 100%. Agency and Key Indicator data have aggregate totals, which contain 

duplicate counts of clients, victims, and perpetrators. The Case Component data, conversely, are 

unique. Case Component data consists of client characteristics, services, and perpetrator 

characteristics, provided by states that have report-level tracking systems. For these reasons, 

readers are cautioned against attempting to compare or combine data reported in Agency, Key 

Indicator, or Case Components.
NAMRS FFY 2016 Report: Case Component 1

Case Component Data

NAMRS Case Component data was provided by states that have case-level tracking capability at 

the state-level, and is comprised of data on client characteristics, services, and perpetrator 

characteristics for each report closed in the NAMRS reporting period (the previous federal fiscal 

year). In order to submit case component data, states had to be able to submit five (5), “required” 

data elements: 

 Unique investigation identifier; 

 Case closure date;

 Unique client identifier; 

 Maltreatment type; 

 Maltreatment disposition; 

 Unique perpetrator identifier (if perpetrator information is submitted).

Outside of the five required elements, states varied on the amount of case-level data they could 

provide. In this first year of data submission to NAMRS by state APS programs, there was 

significant variation across states in the number of data elements submitted and the completeness 

of each record. This impacts the ability to accurately compare data elements across states. 

Subsequently, the reporting of the Case Component characteristics is comprised of a selection of 

states. Furthermore, in case records with a large amount of missing information, we have 

highlighted the proportion of cases with missing information to help caution the reader about 

drawing conclusions or interpretations based on low sample sizes and incomplete information.

The report contains cross-tabulations on a select number of data elements. Considerable effort 

was taken to avoid presenting cross tabulations of data elements with considerable amounts of 

missing information. Therefore, data elements selected for these cross tabulations were based on 

the availability of the data element across several states, again without an overwhelming 

proportion of missing data within those states. For FFY 2016, substantiated maltreatment types 

were prioritized for cross tabulations. Two rules were applied when selecting data elements:

1. States were excluded from a data element cross tabulation exhibit if 25% or more of the 

cases submitted had missing/unknown values for that data element. This is to minimize 

the potential of presenting biased data. Exceptions were made when it is the norm for 

information to be recorded in state data systems only when the characteristic is present and 

not recorded when it is absent. In those cases it is not considered a missing value.

2. If states had apparent inconsistencies for a data element, their data were not included. This 

was applied to one state that reported that 100% of substantiated cases had no previous 

APS reports, and to another state that reported a substantiation rate of only 1.39%.

One final exclusion rule was applied related to self-neglect. Some states record self-neglecters as 

being both the client and the perpetrator; however, this practice is far from universal. To avoid 

confusion, perpetrators were excluded from the review if their only substantiated maltreatment 

type was Self-Neglect. For cross tabulations of perpetrator characteristics, data are not presented 

for Self-Neglect.
NAMRS FFY 2016 Report: Case Component 2

A note on readability - categories for some data elements in exhibits/figures were combined to 

improve visual readability. An example of this is that the three types of Exploitation were 

combined: Exploitation (Non-Specific), Financial Exploitation, and Other Exploitation. For more 

information on any of the data elements and their definitions, see Appendix A: Data Element 

and Value Definitions.

STATE SUBMISSION RATES

“Exhibit DS-1 State Submission Rates” provides component submission details for FFY2016.

Twenty-four states provided Agency Component and Case Component. Twenty states provided 

Agency Component and Key Indicators Component. Ten states provided Agency Component only.

Two states elected not to participate.

Exhibit DS-1 State Submission Rates

Component

# of states 

that 

submitted

% of 

states (56)

# of states 

and 

district

# of 

territories

Did Not Participate 2 3.6% 2 0

Agency Only 10 17.9% 7 3

Agency and Key 

Indicators 20 35.7% 18 2

Agency and Case 24 42.9% 24 0
NAMRS FFY 2016 Report: Case Component 3

CASE COMPONENT – INVESTIGATIONS

IN-1 INVESTIGATION RECORDS SUBMISSION

Case Component submissions of investigation records by 24 states are shown in “Exhibit IN-1

Investigation Records Submission.” A total of 336,764 records were submitted. NAMRS business 

rules require that states submit records with an Investigation Identification and Case Closure Date;

therefore, 100% of the records included these two data elements. In addition, nearly 98.8% 

included the Report Date, 93.9% provided the Investigation Start Date, and 69.3% reported the 

Investigation Disposition Date. Nineteen (19) states were able to provide the Report Source and 

14 states provided the Federal Information Processing Standards (FIPS) Code of the Investigative

Agency.

1

Exhibit IN-1 Investigation Records Submission

Data Element # of states 

submitting

# of 

records 

from states

# of 

records 

with data

% of 

records 

from states 

with data

% of total 

records 

(336,764)

Investigation ID 24 336,764 336,764 100.0% 100.0%

Case Closure Date 24 336,764 336,764 100.0% 100.0%

Report Date 23 333,229 332,597 99.8% 98.8%

Investigation Start Date 22 317,379 316,112 99.6% 93.9%

Report Source 19 288,643 250,051 86.6% 74.3%

Investigation Disposition Date 18 250,020 233,335 93.3% 69.3%

FIPS Code of Investigative 

Agency 14 212,697 209,417 98.5% 62.2%

IN-2A INVESTIGATIONS – REPORT SOURCE AMONG INVESTIGATIONS

“Exhibit IN-2a Investigations – Report Source Among Investigations” lists the possible roles or 

professions of the person who made the report of the suspected adult maltreatment. Multiple report 

sources can be submitted for the investigation. Nineteen states reported at least one report source 

per record (representing 250,051 records of 288,643 total investigation records). The top three 

report sources were Social Services Professional, Medical or Health Professional, and Other 

Professional. Over 13% of investigations submitted marked the report sources as “None or 

Unknown”, which included anonymous reporters. Reasons for “None or Unknown” values may 

include: recorded as Unknown in state reporting system or staff were not able to determine; and 

data records submitted to NAMRS did not contain the information, presumably because the 

information was not collected.

 

1Census Bureau https://www.census.gov/geo/reference/gtc/gtc_codes.html#fips. The Census Bureau and other 

federal agencies assign codes to geographic entities to facilitate the organization, presentation, and exchange of 

statistical data and other information. Federal Information Processing Standards (FIPS) codes are assigned 

alphabetically by geographic name for states, counties, core based statistical areas, places, county subdivisions, 

consolidated cities and all types of American Indian, Alaska Native, and Native Hawaiian (AIANNH) areas
NAMRS FFY 2016 Report: Case Component 4

Exhibit IN-2a Investigations-Report Source Among Investigations

Categories less than 3% and “None or Unknown” not shown above.

Report Sources Among Investigations

# of states 

that 

submitted

Count

% of 

investigations 

(288,643)

Social Services Professional 17 46,216 16.0%

Medical or Health Professional 16 44,989 15.6%

Other Professional 18 37,502 13.0%

Relative 18 35,949 12.5%

Law/Judicial/Legal Professional 19 20,705 7.2%

Self 16 18,632 6.5%

Neighbor/Friend/Nonrelative/Nonprofessional 18 16,308 5.6%

In-Home Caregiver 15 11,874 4.1%

Mental/Behavioral Health Professional 15 8,676 3.0%

Nursing Home Staff 10 8,616 3.0%

Financial Professional 11 5,511 1.9%

Residential Care Community Staff 9 4,289 1.5%

Education Professional 8 1,116 0.4%

Substitute Decision Maker 11 735 0.3%

“None or Unknown” 19 38,592 13.4%

16.0%

15.6%

13.0%

12.5%

7.2%

6.5%

5.6%

4.1%

3.0%

3.0%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Social Services Professional

Medical or Health Professional

Other Professional

Relative

Law/Judicial/Legal Professional

Self

Neighbor/Friend/Nonrelative/Nonprofessional

In-Home Caregiver

Mental/Behavioral Health Professional

Nursing Home Staff
NAMRS FFY 2016 Report: Case Component 5

IN-2B INVESTIGATIONS – MULTIPLE REPORT SOURCES

“Exhibit IN-2b Investigations – Multiple Report Sources” indicates the number of investigations 

with multiple report sources. Most investigations (83.2%) listed only one report source and 13.4%

did not include a report source.

Exhibit IN-2b Investigations–Multiple Report Sources

Investigations with Multiple 

Report Sources # of states # of investigations

% of 

investigations 

(288,643)

No Report Source 19 38,592 13.4%

Only 1 Report Source 19 240,131 83.2%

2 Report Sources 9 9,013 3.1%

3 or More Report Sources 7 907 0.3%

IN-2C INVESTIGATIONS – REPORT SOURCE BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit IN-2c Investigations – Report Source by Substantiated Maltreatment Type” contains data 

submitted by 15 states, with 92,490 investigations represented. Two states’ records were excluded 

from this cross tabulation due to the presence of too much missing data (more than 25%). 

Health/Social Services Professionals were the most common reporters across all maltreatment 

types. Reports were generated by the client or a substitute decision maker at the highest relative 

rates for Abandonment, Emotional Abuse, and Self-Neglect. By contrast, Neglect and Sexual 

Abuse were rarely reported by the client or a substitute decision maker. Sexual Abuse was also 

rarely reported by a relative; relatives were more commonly the reporting party for Emotional 

Abuse and Exploitation. Other Professionals were most commonly the reporters of Sexual Abuse, 

Exploitation, and Physical Abuse. Many states have state laws requiring that professionals report 

suspicious or alleged maltreatments to APS programs.
NAMRS FFY 2016 Report: Case Component 6

Exhibit IN-2c Investigations – Report Source by Substantiated Maltreatment Type

Report Source

All 

Substantiated 

Investigations

Abandonment Emotional 

Abuse Exploitation Neglect Physical Abuse

Sexual 

Abuse

SelfNeglectOther 

Type

Self or Substitute 

Decision Maker 8.5% 13.2% 10.9% 5.3% 2.3% 6.0% 1.9% 9.8% 3.3%

Relative 12.7% 9.4% 17.0% 16.6% 12.0% 9.7% 4.5% 13.2% 8.8%

Neighbor, Friend, 

Other 

Nonrelative/ 

Nonprofessional

5.4% 8.7% 4.6% 6.2% 4.7% 2.5% 1.5% 5.9% 4.7%

In-Home 

Caregiver 4.9% 5.5% 2A5% 3.0% 3.4% 2.7% 1.9% 5.4% 4.8%

Health/Social 

Services 

Professional

42.9% 37.1% 39.3% 32.7% 47.6% 45.2% 50.3% 42.7% 48.8%

Other 

Professional 13.0% 11.9% 16.0% 23.8% 16.0% 21.7% 26.8% 10.8% 15.2%

Multiple Report 

Sources 2.0% 0.1% 0.5% 1.5% 3.9% 2.8% 4.7% 1.8% 2.8%

“None or 

Unknown” 10.6% 14.1% 9.3% 10.8% 10.1% 9.4% 8.4% 10.4% 11.8%

Total 92,490 806 5,138 7,080 8,468 5,210 467 68,265 6,419
NAMRS FFY 2016 Report: Case Component 7

IN-3A INVESTIGATIONS – DURATION

“Exhibit IN-3a Investigations – Duration” displays information from 23 states (333,229 

investigation records submitted with 332,596 records that included duration). Investigation 

duration was defined as the time from case report to case closure. About one third of investigations 

were closed within one month of the report, and another third within the second month. Only a 

small portion of investigations were closed after one year. State APS program policies and 

procedures for the opening and closing of investigation records varies by number of business or 

calendar days, number of days based on the maltreatment type, and review of case record by a 

supervisor.

Exhibit IN-3a Investigations – Duration

Unknown not shown above.

Investigation Duration # of states that 

submitted Count

% of 

investigations 

(333,229)

Less Than 1 Day 21 6,981 2.1%

1-7 Days 23 29,450 8.8%

8-14 Days 23 29,654 8.9%

15-30 Days 23 56,372 16.9%

31-60 Days 23 104,933 31.5%

61-90 Days 23 44,756 13.4%

91-180 Days 23 38,225 11.5%

181-365 Days 23 13,594 4.1%

More Than 365 Days 20 8,631 2.6%

Unknown 7 633 0.2%

2.1%

8.8%

8.9%

16.9%

31.5%

13.4%

11.5%

4.1%

2.6%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Less than 1 Day

1-7 Days

8-14 Days

15-30 Days

31-60 Days

61-90 Days

91-180 Days

181-365 Days

More than 365 Days
NAMRS FFY 2016 Report: Case Component 8

IN-3B INVESTIGATIONS – DURATION BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit IN-3b Investigations – Duration by Substantiated Maltreatment Type” was analyzed 

using the data provided by 21 states (109,259 investigations represented). An investigation 

duration of 14 days or fewer was most common among Sexual Abuse and other abuse cases and 

was relatively rare among cases of Exploitation and Self-Neglect. By contrast, an investigation 

duration of 91 days or more was most common among cases of Exploitation and Neglect and was 

relatively rare among cases of other abuse.

Exhibit IN-3b Investigations – Duration by Substantiated Maltreatment Type Investigation Duration All Substantiated Investigations Abando

nmen

t

Emotional 

Abuse

Exploitation

Neglect

Physical 

Abuse

Sexual 

Abuse

Self-Neglect

Other Type

14 Days or Fewer 13.2% 12.4% 16.0% 9.3% 13.8% 19.5% 28.8% 10.5% 33.7%

15-30 Days 14.5% 14.5% 18.2% 15.9% 14.2% 17.4% 17.7% 13.9% 10.1%

31-60 Days 32.8% 51.1% 24.7% 29.6% 29.0% 28.6% 25.0% 34.2% 32.8%

61-90 Days 16.5% 15.8% 14.4% 14.0% 13.8% 13.0% 8.2% 18.0% 12.5%

91 Days or More 22.8% 6.1% 26.2% 30.8% 28.9% 21.3% 19.9% 23.3% 10.9%

Unknown 0.2% 0.2% 0.4% 0.4% 0.4% 0.3% 0.3% 0.1% -

Total 109,259 856 5,970 10,508 11,247 6,304 587 79,030 6,419
NAMRS FFY 2016 Report: Case Component 9

CASE COMPONENT – CLIENTS

CL-1 CLIENT RECORD SUBMISSION

“Exhibit CL-1 Client Record Submission” displays information about the data that states were able 

to provide relative to clients. Twenty-four states submitted client records (a total of 340,384 client 

records submitted). The one required data element was a unique client identification. The other 

data elements varied in a state’s ability to provide the information. Each data element will be 

discussed in subsequent exhibits.

Exhibit CL-1 Client Record Submission

Data Element # of states 

submitting

# of 

records 

from states

# of 

records 

with 

data

% of 

records 

from 

states with 

data

% of total 

records 

(340,384)

Client ID 24 340,384 340,384 100.0% 100.0%

Gender Identity 24 340,384 332,784 97.8% 97.8%

Age 23 329,691 316,829 96.1% 93.1%

Case Closure Reason 20 308,363 291,384 94.5% 85.6%

Race 22 335,478 267,734 79.8% 78.7%

Previous Report 15 284,656 243,699 85.6% 71.6%

Primary Language 12 243,384 222,378 91.4% 65.3%

FIPS Code of Client Residence 12 213,751 194,694 91.1% 57.2%

Ethnicity 19 315,150 191,231 60.7% 56.2%

Marital Status 16 229,101 139,643 61.0% 41.0%

Living Setting at Close 7 177,199 131,151 74.0% 38.5%

Disabilities 12 213,284 105,585 49.5% 31.0%

Living Setting at Start 9 115,711 81,005 70.0% 23.8%

Maltreatment Setting 8 88,885 78,403 88.2% 23.0%

Behavioral Health Screenings 8 185,096 46,629 25.2% 13.7%

Benefits 8 91,879 34,223 37.2% 10.1%

Services Referred 6 67,580 31,476 46.6% 9.2%

Veteran Status 7 50,347 27,083 53.8% 8.0%

Services at Start 4 63,348 25,113 39.6% 7.4%

Income Level 6 41,257 20,229 49.0% 5.9%

Services APS 5 81,009 18,983 23.4% 5.6%

Services at Close 4 66,326 16,462 24.8% 4.8%

Schooling Level 7 66,976 14,396 21.5% 4.2%

ADL Score 1 16,295 11,772 72.2% 3.5%

IADL Score 1 16,295 11,681 71.7% 3.4%

Employment Status 5 42,201 9,476 22.5% 2.8%

Interagency Coordination 5 63,229 9,194 14.5% 2.7%

Substitute Decision Makers at Start 4 51,893 1,770 3.4% 0.5%

Substitute Decision Makers at Close 4 70,604 820 1.2% 0.2%

Sexual Orientation 1 16,615 473 2.8% 0.1%
NAMRS FFY 2016 Report: Case Component 10

CL-2 CLIENTS – MALTREATMENT SETTING

“Exhibit CL-2 Clients – Maltreatment Setting” provides information about the location where the 

alleged maltreatment occurred. Of the eight states providing data (78,403 client records included 

setting), 73.6% of the maltreatments occurred in the client’s own residence or private residence of 

a relative caregiver. Of these states, two state APS programs investigate reports of adults in 

Own/Private Residence of Client/Caregiver, and six programs investigate reports of adult 

maltreatment in both private residences and licensed nursing home and residential care 

communities. The second highest rate was 5.2%, where the client was classified as “other 

settings.” Approximately 12% of these states recorded the setting as “Unknown.” 

Exhibit CL-2 Clients – Maltreatment Setting

Categories less than one percent and Unknown not shown above.

Clients by Maltreatment Setting # of states 

submitting Count % of clients (88,885)

Own/Private Residence of Client/Caregiver 8 65,437 73.6%

Other Setting 7 4,643 5.2%

Nursing Home (Non-Specific) 5 3,232 3.6%

Residential Care Community (Non-Specific) 4 3,082 3.5%

Licensed Nursing Home 3 1,066 1.2%

Place of Business or Other Services 4 521 0.6%

Licensed Residential Care Community 4 223 0.3%

Unlicensed Residential Care Community 2 68 0.1%

Unlicensed Nursing Home 2 57 0.1%

Adult Day Services Center (Non-Specific) 2 52 0.1%

Licensed Adult Day Services Center 2 22 0.02%

Unlicensed Adult Day Services Center 0 - -

Unknown 19 10,482 11.8%

CL-3A CLIENTS – CASE CLOSURE REASON

“Exhibit CL-3a Clients – Case Closure Reason” provides the reasons for closure of a client’s case.

Twenty states submitted these data (308,363 client records of which 291,384 included closure 

73.6%

5.2%

3.6%

3.5%

1.2%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Own/Private Residence of Client/Caregiver

Other Setting

Nursing Home (Non-Specific)

Residential Care Community (Non-Specific)

Licensed Nursing Home
NAMRS FFY 2016 Report: Case Component 11

reason). Clients that received investigative services only were reported as Investigation Completed 

or Investigation Not Completed. If both investigative and protective services were provided to the 

victim or “at-risk” client, their case would be reported as Investigative/Protective Services 

Completed or Protective Services Closed/Not Completed. Reporting states complete an 

investigation as part of the APS protocol. It is worth noting that some states allow adults with 

capacity to refuse an investigation and other states proceed with an investigation regardless of 

client refusal. APS programs may offer a range of short- or long-term services to clients or refer 

them for services provided by other organizations. Adult clients, who have not been adjudicated 

incompetent by a court of law, may accept or refuse services. 

Exhibit CL-3a Clients – Case Closure Reason

Categories less than one percent and Unknown not shown above.

Clients by Closure Reason # of states 

submitting Count % of clients (308,363)

Investigation Completed 16 149,707 48.5%

Investigation/Protective Services Completed 15 83,794 27.2%

Other Closure Reason 12 23,522 7.6%

Investigation Not Completed (Non-Specific) 11 14,349 4.7%

Investigation Not Completed (Client Refusal) 8 6,461 2.1%

Investigation Not Completed (Client Death) 8 4,732 1.5%

Protective Services Closed (Client Decision) 10 4,009 1.3%

Protective Services Not Completed (Non-Specific) 7 2,495 0.8%

Protective Services Closed (Client Death) 9 2,315 0.8%

Unknown 20 16,979 5.5%

48.5%

27.2%

7.6%

4.7%

2.1%

1.5%

1.3%

0% 10% 20% 30% 40% 50% 60%

Investigation Completed

Investigation/Protective Services Completed

Other Closure Reason

Investigation Not Completed (Non-Specific)

Investigation Not Completed (Client Refusal)

Investigation Not Completed (Client Death)

Protective Services Closed (Client Decision)
NAMRS FFY 2016 Report: Case Component 12

CL-3B VICTIMS – CASE CLOSURE REASONS BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit CL-3b Victims – Case Closure Reasons by Substantiated Maltreatment Type” indicates 

that Investigation/Services Completed was the most common reason for case closure across all 

types of maltreatment. Eighteen states submitted these data (representing a total of 100,159 

victims). Investigation/services being incomplete due to client death was relatively common in 

cases of Neglect and Self-Neglect. Investigation/services being incomplete at the request or refusal 

of the client occurred most for cases of Emotional Abuse, followed by Physical Abuse and SelfNeglect.

Exhibit CL-3b Victims – Case Closure Reasons by Substantiated Maltreatment Type Case Closure Reason All Victims Abandonment Emotional

Abuse

Exploitation

Neglect

Physical 

Abuse

Sexual 

Abuse

Self-Neglect

Other Type

Investigation/Services 

Completed 80.0% 70.4% 67.5% 75.2% 74.4% 78.0% 78.2% 81.6% 67.3%

Investigation/Services 

Incomplete/Client 

Death

3.3% 1.3% 1.5% 2.6% 4.7% 1.5% 1.2% 3.6% 2.3%

Investigation/Services 

Incomplete at 

Request/Refusal of 

Client

7.0% 1.8% 11.4% 6.1% 4.3% 8.0% 4.6% 7.5% 3.9%

Investigation/Services 

Incomplete, Other 2.2% 10.8% 0.9% 1.9% 2.2% 1.3% 1.5% 2.1% 9.2%

Other Reason 6.8% 15.8% 18.4% 12.9% 13.3% 10.0% 14.1% 4.5% 16.9%

Unknown 0.7% 0.0% 0.3% 1.3% 1.1% 1.1% 0.4% 0.6% 0.6%

Total 100,159 856 5,432 9,775 9,864 5,674 524 74,873 4,165

CL-4A CLIENTS – AGE GROUP

“Exhibit CL-4a Clients – Age Group” displays the data relevant to the age of clients. The age of 

the client is determined at the start of the investigation. Client ages were categorized in similar 

groups as those used during Key Indicator Component data submission. Comparisons between 

categories must take into account the number of clients represented each year (i.e., average number 

of clients per year of age). The top age grouping for clients was 75-84 years, and the highest 

average number of clients per year of age was within the 70-74, 65-69, and 75-84 age groups. The 

age for 3.9% of the client records was unknown. Reasons for Unknown values may include:

recorded as Unknown in state reporting system or staff were not able to determine; and data records 

submitted to NAMRS did not contain the information, presumably because the information was 

not collected.

Twenty-three states provided data for the age of clients (329,691 client records of which 316,829 

included age). Twenty-two of the states investigate maltreatment allegations of adults 18 years of 
NAMRS FFY 2016 Report: Case Component 13

age and older. One state only investigates maltreatment allegations of the adult 60 years and older 

population.

Exhibit CL-4a Clients – Age Group

Unknown not shown above.

Age Group # of states that 

submitted Count % of clients (329,691)

Age 18-29 23 21,671 6.6%

Age 30-39 22 16,063 4.9%

Age 40-49 22 19,949 6.1%

Age 50-59 23 40,083 12.2%

Age 60-64 23 28,883 8.8%

Age 65-69 23 35,872 10.9%

Age 70-74 23 35,984 10.9%

Age 75-84 23 70,170 21.3%

Age 85+ 23 48,154 14.6%

Unknown 17 12,862 3.9%

CL-4B VICTIMS – AGE GROUP BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit CL-4b Victims – Age Group by Substantiated Maltreatment Type” displays the data 

relevant to the age of victims. The age of a person is determined at the start of the investigation. 

Data for the age of clients were provided by 20 states (representing 101,588 victims). One state’s 

records were excluded from this cross tabulation due to too much missing data (more than 25%). 

Younger victims, under the age of 60, were most common among cases of Sexual Abuse and 

Abandonment. Older victims, aged 70 years and over, were most common among cases of 

Exploitation, followed by Neglect and Emotional Abuse.

6.6%

4.9%

6.1%

12.2%

8.8%

10.9%

10.9%

21.3%

14.6%

0% 5% 10% 15% 20% 25%

Age 18-29

Age 30-39

Age 40-49

Age 50-59

Age 60-64

Age 65-69

Age 70-74

Age 75-84

Age 85+
NAMRS FFY 2016 Report: Case Component 14

Exhibit CL-4b Victims – Age Group by Substantiated Maltreatment Type

Age Group All 

Victims

AbandonmentEmotional 

Abuse

Exploitation Neglect Physical 

Abuse

Sexual 

Abuse

SelfNeglectOther 

Type

18-39 7.9% 14.8% 9.4% 5.3% 14.6% 16.6% 49.4% 5.8% 14.9%

40-59 19.2% 33.7% 15.0% 10.6% 15.9% 17.7% 16.9% 20.2% 23.7%

60-64 10.3% 13.4% 9.8% 7.0% 7.1% 9.0% 5.6% 11.3% 10.0%

65-69 13.2% 11.1% 13.5% 11.3% 9.3% 12.5% 5.1% 14.4% 9.5%

70-74 12.6% 8.9% 12.7% 12.1% 9.6% 11.3% 3.6% 13.3% 9.5%

75-84 22.3% 14.3% 24.3% 30.2% 21.8% 19.4% 10.3% 22.2% 18.8%

85+ 13.4% 3.6% 14.0% 21.1% 19.6% 11.1% 8.3% 12.0% 13.0%

Unknown 1.2% 0.1% 1.2% 2.5% 2.1% 2.5% 0.8% 0.8% 0.6%

Total 101,588 830 5,635 9,345 9,676 6,025 532 73,294 6,542

CL-5A CLIENTS – GENDER IDENTITY

“Exhibit CL-5a Clients – Gender Identity” reflects the clients’ gender identity data reported by 24 

states (340,384 client records, of which 332,784 included gender identity). Female clients made 

up 57.7% of all clients, with male clients making up 40%. Only two states were able to report 

transgender identity. A gender identity was not included in 2.2% of the client records submitted 

and were classified as Unknown. Reasons for Unknown values may include: recorded as Unknown 

in state reporting system or staff were not able to determine; and data records submitted to NAMRS 

did not contain the information, presumably because the information was not collected.

Exhibit CL-5a Clients – Gender Identity

Transgender not shown above.

Male, 40.0%

Female, 57.7%

Unknown, 2.2%
NAMRS FFY 2016 Report: Case Component 15

Gender Identity # of states that 

submitted Count % of clients (340,384)

Male 24 136,303 40.0%

Female 24 196,473 57.7%

Transgender 2 8 0.002%

Unknown 20 7,600 2.2%

CL-5B CLIENTS – GENDER IDENTITY BY SUBSTANTIATED MALTREATMENT TYPE

Twenty-two states provided information regarding a victim’s gender (representing 110,237 

victims). Female victims were most common in cases of Sexual Abuse and Emotional Abuse. Male 

victims were more common among cases of Abandonment, which had a nearly even split, male to 

female.

Exhibit CL-5b Clients – Gender Identity by Substantiated Maltreatment Type

Transgender and Unknown not shown above.

50.1%

29.2%

38.9%

39.8%

35.2%

21.4%

41.6%

42.5%

49.9%

69.9%

58.4%

59.0%

63.4%

78.5%

57.6%

56.9%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Abandonment

Emotional Abuse

Exploitation

Neglect

Physical Abuse

Sexual Abuse

Self-Neglect

Other Type

Male

Female
NAMRS FFY 2016 Report: Case Component 16

Gender 

Identity

All 

Victims

AbandonmentEmotional AbuseExploitat

ion Neglect Physical Abuse

Sexual 

Abuse

SelfNeglect Other 

Male 40.7% 50.1% 29.2% 38.9% 39.8% 35.2% 21.4% 41.6% 42.5%

Female 58.3% 49.9% 69.9% 58.4% 59.0% 63.4% 78.5% 57.6% 56.9%

Transgender - - - - - - - - -

Unknown 1.1% - 0.9% 2.7% 1.2% 1.4% 0.2% 0.8% 0.7%

Total 110,237 874 6,099 10,676 11,283 6,453 594 79,483 6,542

CLIENTS – SEXUAL ORIENTATION

Sexual orientation is not a common data element collected by APS programs. One state submitted 

sexual orientation for 473 of its 16,615 client records. Over 97% of the client records submitted 

by the one state indicated the sexual orientation of the client was unknown, which may be an 

indication that the clients did not choose to answer the question or workers have not asked the 

client the question.

CL-6A CLIENTS – RACE

Twenty-two states reported data on clients’ race as displayed in “Exhibit CL-6a Clients – Race.”

A total of 335,478 records were submitted by these states and 267,734 of these included at least 

one race. States are permitted to report multiple races for one individual. Most of the clients, 57%, 

were classified as being white and 14.2% reported being black or African American. The race was 

unknown for 20.2% of client records. Reasons for Unknown values may include: recorded as 

Unknown in state reporting system or staff were not able to determine; and data records submitted 

to NAMRS did not contain the information, presumably because the information was not collected.

Exhibit CL-6a Clients – Race

Unknown not shown above.

57.0%

14.2%

7.6%

0.9%

0.7%

0.2%

0% 10% 20% 30% 40% 50% 60%

White

Black or African American

Other Race

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander
NAMRS FFY 2016 Report: Case Component 17

Race # of states that 

submitted Count % of clients (335,478)

White 22 191,147 57.0%

Black or African American 22 47,596 14.2%

Other Race 13 25,525 7.6%

American Indian or Alaska Native 20 2,903 0.9%

Asian 20 2,406 0.7%

Native Hawaiian or Other Pacific 

Islander 18 557 0.2%

Unknown 19 67,744 20.2%

CL-6B CLIENTS – MULTIPLE RACES

“Exhibit CL-6b Clients – Multiple Races” indicates the number of clients with multiple races. The 

majority of client records,79.1%, listed only one race and 20.2% did not include a race.

Exhibit CL-6b Clients – Multiple Races

Clients with Multiple Races # of states # of clients % of clients 

(335,478)

No Race 22 67,744 20.2%

Only 1 Race 22 265,382 79.1%

2 Races 9 2,312 0.7%

3 or More Races 5 40 0.01%

CL-7 CLIENTS – ETHNICITY

“Exhibit CL-7 Clients – Ethnicity” includes data reported by 19 states (a total of 315,150 client 

records, of which 191,231 included ethnicity). Most clients, 49.8%, were classified as Not 

Hispanic, Latino/a, or Spanish. A smaller percentage, 10.9%, were classified as Hispanic, Latino/a, 

or Spanish and the ethnicity was unknown for 39.3% of clients. Reasons for Unknown values may 

include: recorded as Unknown in state reporting system or staff were not able to determine; and 

data records submitted to NAMRS did not contain the information, presumably because the 

information was not collected.
NAMRS FFY 2016 Report: Case Component 18

Exhibit CL-7 Clients – Ethnicity

Ethnicity # of states 

submitting Count % of clients (191,231)

Hispanic, Latino/a, or Spanish 19 34,212 10.9%

Not Hispanic, Latino/a, or Spanish 15 157,019 49.8%

Unknown 19 123,919 39.3%

CL-8A CLIENTS – RACE/ETHNICITY

Fifteen states submitted data on race/ethnicity (256,290 total records submitted of which 225,062 

contained at least one race). Per convention, race/ethnicity is assigned as Hispanic/Latino for 

everyone reporting a Hispanic/Latino ethnicity. All non-Hispanic/Latino individuals who reported 

multiple races were classified as such; all other non-Hispanic/Latino individuals were assigned a 

single race. Non-Hispanic whites accounted for 51.2% of clients, while 0.9% had multiple races 

recorded.

Exhibit CL-8a Clients – Race/Ethnicity

Categories less than one percent and Unknown not shown above.

Hispanic

10.9%

Not Hispanic

49.8%

Unknown

39.3%

51.2%

15.3%

12.9%

6.3%

0% 10% 20% 30% 40% 50% 60%

White

Black/African American

Hispanic/ Latino

Other (Non-Hispanic)
NAMRS FFY 2016 Report: Case Component 19

Race/Ethnicity

# of states 

that 

submitted

Count % of clients 

(256,290)

White 15 131,306 51.2%

Black/African American 15 39,242 15.3%

Hispanic/Latino 13 33,127 12.9%

Other (Non-Hispanic) 9 16,140 6.3%

American Indian/Alaska Native 14 855 0.3%

Asian 14 1,771 0.7%

Native Hawaiian/Other Pacific Islander 15 396 0.2%

Multiple Races (Non-Hispanic) 7 2,225 0.9%

Unknown 13 31,228 12.2%

CL-8B VICTIMS – RACE/ETHNICITY BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit CL-8b Victims – Race/Ethnicity by Substantiated Maltreatment Type” displays the data 

of race and ethnicity of the victim together. Thirteen states are included in this exhibit, representing 

86,543 victims. An additional seven states’ records were excluded from this cross tabulation due 

to too much missing data (more than 25%). White victims were most common among Other Type

and least common among Self-Neglect. Black/African American victims were most common 

among cases of Neglect and least common among Other Type. Other Type examples provided by 

states are isolation, abduction, and inability to give informed consent. Hispanic/Latino victims 

were most common among cases of Self-Neglect and least common among cases of Abandonment.
NAMRS FFY 2016 Report: Case Component 20

Exhibit CL-8b Victims – Race/Ethnicity by Substantiated Maltreatment Type

Race/Ethnicity All 

Victims Abandonment Emotional Abuse Exploitation Neglect Physical Abuse

Sexual 

Abuse

SelfNeglectOther 

Type

White 55.0% 69.2% 69.3% 67.0% 60.3% 65.7% 65.0% 51.7% 74.3%

Black/African 

American 18.1% 17.9% 14.7% 17.7% 21.2% 13.8% 15.4% 18.4% 13.1%

Hispanic/ Latino 13.8% 0.7% 6.1% 4.3% 7.5% 9.0% 7.0% 16.4% 0.8%

Other (nonHispanic) 1.8% 9.9% 3.8% 3.4% 2.8% 2.5% 3.8% 1.0% 9.0%

American 

Indian/Alaska 

Native

0.2% 0.1% 0.2% 0.3% 0.2% 0.2% 1.0% 0.2% 0.3%

Asian 0.6% 0.2% 0.4% 0.6% 0.6% 0.6% 0.7% 0.6% 0.4%

Native Hawaiian/

Other PI 0.1% - 0.5% 0.2% 0.4% 0.4% 0.5% 0.1% -

Multiple Races 

(non-Hispanic) 0.9% 0.1% 0.8% 0.6% 1.5% 1.1% 0.7% 0.8% 0.1%

Unknown 9.5% 1.8% 4.0% 5.9% 5.5% 6.5% 6.0% 10.6% 2.0%

Total 86,543 818 5,009 6,591 8,053 4,802 417 66,362 3,257
NAMRS FFY 2016 Report: Case Component 21

CL-9 CLIENTS – PRIMARY LANGUAGE

Twelve states reported the clients’ primary language (243,384 client records, of which 222,378

included language), depicted in “Exhibit CL-9a Clients – Primary Language.” Of those records, 

English was identified as the primary language for 83.7% and Spanish or Spanish Creole for 4.7% 

of clients. NAMRS has 11 other primary language choices including Sign Language and Assistive 

Technology. When combined, these choices comprised three percent of responses. Additional 

details for all language choices can be found in “Exhibit CL-9b Clients – Primary Language 

(Details).”

Exhibit CL-9a Clients – Primary Language

Primary Language # of states submitting Count % of clients (243,384)

English 12 203,744 83.7%

Spanish 12 11,332 4.7%

Other Language 12 7,302 3.0%

Unknown 12 21,006 8.6%

Exhibit CL-9b Clients – Primary Language (Details)

Primary Language # of States Count % of Clients (243,384)

English 12 203,744 83.7%

Spanish 12 11,332 4.7%

Other Language 12 5,590 2.3%

Sign Language 6 373 0.2%

Russian 9 351 0.1%

French 7 270 0.1%

Chinese 8 255 0.1%

Vietnamese 10 189 0.1%

Korean 8 144 0.1%

Arabic 7 73 0.03%

German 6 31 0.01%

Tagalog 4 26 0.01%

Assistive Technology 0 - -

Unknown 12 21,006 8.6%

English, 83.7%

Spanish, 4.7%

Other, 3.0%

Unknown, 8.6%
NAMRS FFY 2016 Report: Case Component 22

CL-10 CLIENTS – SCHOOLING LEVEL

Seven states provided the clients’ highest education level (66,976 records submitted with 14,396 

of these including schooling level), which was submitted for 21.5% of clients in those states. The 

category with the highest percentage of clients reported was High School Diploma or Equivalent 

at 12.8%. The next highest response was "Less than High School at 7.3%. The other school levels, 

Associate’s or Bachelor’s Degree and Advanced Degree, combined for 1.4% of responses. The 

clients’ schooling level was unknown for 78.5% of clients. Reasons for Unknown values may 

include: recorded as Unknown in state reporting system or staff were not able to determine; and 

data records submitted to NAMRS did not contain the information, presumably because the 

information was not collected.

Exhibit CL-10 Clients – Schooling Level

Unknown not shown above.

Schooling Level # of states that 

submitted Count % of clients (66,976)

Less Than High School 6 4,881 7.3%

High School Diploma or Equivalent 6 8,565 12.8%

Associate’s Degree Or Bachelor’s 

Degree 7 814 1.2%

Advanced Degree 5 136 0.2%

Unknown 7 52,580 78.5%

CL-11A CLIENTS – MARITAL STATUS

“Exhibit CL-10a Clients – Marital Status” indicates that 16 states reported the marital status of 

clients (229,101 total client records submitted with 139,643 records that included marital status).

The top three statuses were Never Married at 17%, Widowed at 14.7%, and Married at 13.7%. The 

other statuses listed were Divorced, Other, Separated, and Domestic Partner (including Civil 

Union). The marital status was unknown for over 39% of the client records. Reasons for Unknown 

values may include: recorded as Unknown in state reporting system or staff were not able to 

determine; and data records submitted to NAMRS did not contain the information, presumably 

because the information was not collected.

7.3%

12.8%

1.2%

0.2%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Less Than High School

High School Diploma or Equivalent

Associate’s Degree or Bachelor’s Degree

Advanced Degree
NAMRS FFY 2016 Report: Case Component 23

Exhibit CL-11a Clients – Marital Status

Unknown not shown above.

Marital Status # of states that 

submitted Count % of clients (229,101)

Never Married 15 38,932 17.0%

Widowed 15 33,614 14.7%

Married 16 31,334 13.7%

Divorced 16 22,462 9.8%

Other Status 10 10,069 4.4%

Separated 13 3,079 1.3%

Domestic Partner (including Civil Union) 5 153 0.1%

Unknown 16 89,458 39.0%

CL-11B VICTIMS – MARITAL STATUS BY SUBSTANTIATED MALTREATMENT TYPE

Seven states’ data contributed to “Exhibit CL-10b Victims – Marital Status by Substantiated 

Maltreatment Type.” A total of 15,390 victims are represented. An additional eight states’ records 

were excluded from this cross tabulation due to too much missing data (more than 25%). Never 

Married was most common among victims of Sexual Abuse, 43%, followed by Abandonment at 

37.1%, and Self-Neglect at 25.7%. Married/Partnered was most common among victims of 

Emotional Abuse at 25.4%, followed by Physical Abuse at 25%, and Neglect at 23.7%. Being 

divorced or separated was most common among victims of Emotional Abuse at 36.2%, followed 

by Exploitation at 31.9% and Physical Abuse at 26.1%. Widowed was most common among 

victims of Other Type with 25.2%. Other Status was most common among victims of Self-Neglect 

with 24.9%.

17.0%

14.7%

13.7%

9.8%

4.4%

1.3%

0.1%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Never Married

Widowed

Married

Divorced

Other Status

Separated

Domestic Partner
NAMRS FFY 2016 Report: Case Component 24

Exhibit CL-11b Victims – Marital Status by Substantiated Maltreatment Type

Marital Status All 

Victims

AbandonmentEmotional AbuseExploitation Neglect Physical 

Abuse

Sexual 

Abuse

SelfNeglectOther 

Type

Never Married 20.4% 37.1% 14.7% 12.3% 18.6% 20.0% 43.0% 25.7% 17.9%

Married/ 

Partnered 18.3% 15.7% 25.4% 21.7% 23.7% 25.0% 10.0% 11.2% 16.9%

Divorced/ 

Separated 22.3% 10.0% 36.2% 31.9% 24.3% 26.1% 20.0% 13.0% 22.2%

Widowed 19.5% 12.9% 16.5% 20.6% 19.6% 18.5% 16.3% 19.6% 25.2%

Other Status 14.4% 22.9% 2.8% 7.8% 8.4% 7.0% 7.0% 24.9% 9.6%

Unknown 5.1% 1.4% 4.3% 5.8% 5.4% 3.4% 3.7% 5.6% 8.3%

Total 15,390 70 2,901 3,575 3,836 2,006 300 6,212 722

CL-12 CLIENTS – EMPLOYMENT STATUS

“Exhibit CL-12 Clients – Employment Status” indicates five states included data on employment 

status for 9,476 of 42,201 client records. Only 1.8% of records indicated that the client was 

employed, while 19.4% indicated the employment status of Not in the Labor Force.

Exhibit CL-12 Clients – Employment Status

Categories less than one percent and Unknown not shown above.

Employment Status # of states that submitted Count % of clients (42,201)

Not in Labor Force 3 8,199 19.4%

Employed 3 762 1.8%

Unemployed 3 498 1.2%

Other Status 3 17 0.04%

Unknown 5 32,725 77.5%

19.4%

1.8%

1.2%

0% 5% 10% 15% 20% 25%

Not in Labor Force

Employed

Unemployed
NAMRS FFY 2016 Report: Case Component 25

CL-13 CLIENTS – INCOME LEVEL

Six states reported the income level of the client, shown in “Exhibit CL-13 Clients – Income Level” 

(41,257 client records submitted of which 20,229 include income level). A total of 43.4% of client 

records indicated an income that was less than $25,000. If known, the level of annual income of 

the client including all sources (public and private) is provided. The income level for 51% of the 

client records submitted by the six states was unknown. Reasons for Unknown values may include: 

recorded as Unknown in state reporting system or staff were not able to determine; and data records 

submitted to NAMRS did not contain the information, presumably because the information was 

not collected.

Exhibit CL-13 Clients – Income Level

Categories less than one percent and Unknown not shown above.

Income Level

# of states 

that 

submitted

Count % of clients 

(41,257)

Less Than $25,000 6 17,904 43.4%

$25,000-$49,999 5 1,954 4.7%

$50,000-$74,999 6 266 0.6%

$75,000-$99,999 5 51 0.1%

$100,000 or More 4 54 0.1%

Unknown 6 21,028 51.0%

CL-14A CLIENTS – BENEFITS

“Exhibit CL-15a Clients – Benefits” shows eight states provided data on the benefits received by 

clients (91,879 client records submitted of which 34,223 included at least one benefit). Multiple 

benefits could be submitted for each client. The top four benefits were Medicare at 13.6%, Social 

Security Income at 12.4%, Medicaid at 11.9%, and Social Security Retirement at 11.2%. Other 

benefits include Social Security Disability Insurance, Publicly-Subsidized Housing, Temporary

Assistance for Needy Families (TANF), Veterans’ Disability, and Other. Benefits received was 

unknown for 62.8% of client records submitted by the eight states. Reasons for Unknown values 

may include: recorded as Unknown in state reporting system or staff were not able to determine; 

and data records submitted to NAMRS did not contain the information, presumably because the 

information was not collected.

43.4%

4.7%

0% 10% 20% 30% 40% 50%

Less Than $25,000

$25,000-$49,999
NAMRS FFY 2016 Report: Case Component 26

Exhibit CL-14a Clients – Benefits

Categories less than one percent and Unknown not shown above.

Benefits # of states 

submitting Count

% of 

clients 

(91,879)

Medicare 6 12,482 13.6%

Supplemental Security Income (SSI) 7 11,350 12.4%

Medicaid 5 10,910 11.9%

Social Security Retirement Benefits 7 10,257 11.2%

Other Benefits 3 5,143 5.6%

Social Security Disability Insurance (SSDI) 4 665 0.7%

Veterans’ Disabled Benefits 5 366 0.4%

Publicly-Subsidized Housing 1 19 0.02%

Temporary Assistance for Needy Families (TANF) 2 7 0.01%

Unknown 8 57,656 62.8%

CL-14B CLIENTS – MULTIPLE BENEFITS

“Exhibit CL-14b Clients – Multiple Benefits” indicates that 21.8% of the clients received one 

benefit, 12.7% received two benefits, and 2.8% received three or more benefits. 

Exhibit CL-14b Clients – Multiple Benefits

Clients with Multiple Benefits # of states # of clients % of clients 

(91,879)

No Benefit 8 57,656 62.8%

Only 1 Benefit 7 20,032 21.8%

2 Benefits 8 11,635 12.7%

3 or More Benefits 6 2,556 2.8%

13.6%

12.4%

11.9%

11.2%

5.6%

0% 2% 4% 6% 8% 10% 12% 14%

Medicare

Supplemental Security Income (SSI)

Medicaid

Social Security Retirement Benefits

Other Benefits
NAMRS FFY 2016 Report: Case Component 27

CL-15 CLIENTS – VETERAN STATUS

Seven states (50,347 client records submitted of which 27,083 included veteran status) indicated 

veteran status on about 54% of the client records they submitted. The pie chart in “Exhibit CL-15 

Clients – Veteran Status” reflects that 4.2% of clients were veterans and 49.6% were not veterans.

Exhibit CL-15 Clients – Veteran Status

Veteran Status # of states that 

submitted Count % of clients (50,347)

Veteran 6 2,127 4.2%

Non-Veteran 7 24,956 49.6%

Unknown 7 23,264 46.2%

CL-16A CLIENTS – DISABILITIES

“Exhibit CL-16a Clients – Disabilities” reflects clients’ disabilities data from 12 states (213,284 

client records submitted of which 105,585 included at least one disability). Disabilities include the 

clients’ physical, emotional, and cognitive difficulties that result in limitation in activities and 

restrictions to fully participate at school, work, or in the community. The three highest reported 

difficulties experienced by clients were Ambulatory at 24.1%, Cognitive at 23%, and Independent 

Living at 13.3%. The other difficulties included Communication, Hearing, Self-Care, Vision, and 

Other Difficulty (disability not listed). The value of None/Unknown indicates that there was no

disability determined or it was unknown if the client had a disability.

Veteran, 4.2%

Non-Veteran, 49.6%

Unknown, 46.2%
NAMRS FFY 2016 Report: Case Component 28

Exhibit CL-16a Clients – Disabilities

“None or Unknown” not shown above.

Disability # of states that 

submitted Count % of clients (213,284)

Ambulatory 8 51,331 24.1%

Cognitive 12 49,077 23.0%

Independent Living 7 28,319 13.3%

Self-Care 7 13,930 6.5%

Communication 9 7,671 3.6%

Other Difficulty 7 6,483 3.0%

Vision 6 5,518 2.6%

Hearing 5 5,023 2.4%

“None or Unknown” 12 107,699 50.5%

CL-16B CLIENTS – MULTIPLE DISABILITIES

“Exhibit CL-16b Clients – Multiple Disabilities” indicates the number of clients with multiple 

disabilities. The majority of client records, 50.5%, had no client disability as reported by 12 states. 

Eleven states’ client records had only one disability for 30.7% of clients. Ten states reported that 

11.5% of clients had two disabilities. Nine states’ client records indicated that 5.1% of clients had 

three disabilities, and 2.3% of clients had four or more disabilities.

24.1%

23.0%

13.3%

6.5%

3.6%

3.0%

2.6%

2.4%

0% 5% 10% 15% 20% 25% 30%

Ambulatory

Cognitive

Independent Living

Self-Care

Communication

Other Difficulty

Vision

Hearing
NAMRS FFY 2016 Report: Case Component 29

Exhibit CL-16b Clients – Multiple Disabilities

Clients with Multiple 

Disabilities # of states # of clients % of clients (213,284)

No Disability 12 107,699 50.5%

Only 1 Disability 11 65,419 30.7%

2 Disabilities 10 24,464 11.5%

3 or More Disabilities 9 10,807 5.1%

4 or More Disabilities 9 4,895 2.3%

CL-16C VICTIMS – DISABILITIES BY SUBSTANTIATED MALTREATMENT TYPE 

“Exhibit CL-16c Victims – Disabilities by Substantiated Maltreatment Type” reflects data from 

nine states(representing 72,138 victims). Cognitive Difficulty was noted frequently among victims 

of Abandonment, followed by victims of Neglect and other abuse. Communication/Sensory 

Difficulty (including communication difficulty, hearing difficulty, and vision difficulty) was also 

noted frequently for victims of Abandonment but, was relatively infrequently noted among victims 

of Physical Abuse and Self-Neglect. Functional Difficulty (including ambulatory difficulty, 

independent living difficulty, and self-care difficulty) was very frequently noted among victims of 

Abandonment and Self-Neglect but, was relatively infrequently noted among victims of Physical 

Abuse.

Exhibit CL-16c Victims – Disabilities by Substantiated Maltreatment Type Disabilities All Victims Abandonment Emotional Abuse Exploitation Neglect Physical Abuse Sexual Abuse Self-Neglect

Other Type

Cognitive Difficulty 16.2% 61.1% 12.1% 19.3% 33.1% 11.2% 20.0% 14.8% 31.8%

Communication/Sensory 

Difficulty 8.6% 27.8% 13.6% 13.3% 16.7% 1.9% 12.0% 7.7% 14.9%

Functional Difficulty 40.5% 83.3% 17.2% 23.7% 31.3% 4.6% 24.1% 45.6% 23.1%

Other Difficulty 2.0% - 3.8% 4.7% 5.4% 4.2% 4.7% 1.2% 6.2%

Total 72,138 18 3,162 4,279 6,018 2,730 3,482 57,931 195

CL-17 CLIENTS – ADL AND IADL SCORE

One state provided client scores for activities of daily living (ADL) and instrumental activities of 

daily living (IADL), as shown in “Exhibit CL-17 Clients – ADL and IADL Score.” This exhibit 

includes 11,772 records with an ADL score and 11,681 records with an IADL score (of 16,295 

records). ADL and IADL scores were unknown for 28.3% of client records. Reasons for Unknown 
NAMRS FFY 2016 Report: Case Component 30

values may include: recorded as Unknown in state reporting system or staff were not able to 

determine; and data records submitted to NAMRS did not contain the information, presumably 

because the information was not collected. Many states use the ADL and IADL assessment 

instruments, but do not record the information as a data element in the state reporting system.

“ADL are self-care activities that a person performs daily (e.g., eating, dressing, bathing, 

transferring between the bed and a chair, using the toilet, controlling bladder and bowel functions). 

IADL are activities that are needed to live independently (e.g., doing housework, preparing meals, 

taking medications properly, managing finances, using a telephone).” 2

Exhibit CL-17 Clients – ADL and IADL Score

Unknown not shown above.

Score ADL score 

counts % of clients (16,295) IADL score counts

% of clients 

(16,295)

0 1,928 11.8% 477 2.9%

1 773 4.7% 297 1.8%

2 728 4.5% 223 1.4%

3 738 4.5% 281 1.7%

4 837 5.1% 383 2.4%

5 2,090 12.8% 966 5.9%

6 4,678 28.7% 1,426 8.8%

7 NA NA 2,668 16.4%

8 NA NA 4,960 30.4%

Unknown 4,523 27.8% 4,614 28.3%

 

2

Source: American Academy of Family Physicians. “The Geriatric Assessment.” Retrieved from:

http://www.aafp.org/afp/2011/0101/p48.html.

0% 5% 10% 15% 20% 25% 30% 35%

0

1

2

3

4

5

6

7

8

Score

ADL IADL
NAMRS FFY 2016 Report: Case Component 31

CL-18A CLIENTS – BEHAVIORAL HEALTH CONDITIONS

NAMRS has eight distinct behavioral health screenings or diagnoses data elements plus Other.

Multiple behavioral health conditions can be submitted for the client. Eight states reported on

clients’ behavioral health screenings or diagnoses (185,096 client records, of which 46,629 

contained at least one condition). “Exhibit CL-18a Clients – Behavioral Health Conditions”

displays the top three behavioral health conditions of clients: Other, Dementia, and Depression.

Some state examples of Other are delusional, organic brain syndrome, borderline personality, and 

emotional disorder. Reasons for Unknown values may include: recorded as Unknown in state 

reporting system or staff were not able to determine; and data records submitted to NAMRS did 

not contain the information, presumably because the information was not collected.

Exhibit CL-18a Clients – Behavioral Health Conditions

“None or Unknown” not shown above.

Behavioral Health Condition

# of states 

that 

submitted

Count % of clients 

(185,096)

Other Condition 5 29,674 16.0%

Dementia 4 8,043 4.3%

Depression 4 3,686 2.0%

Substance Use Disorder 3 2,986 1.6%

Anxiety 3 2,451 1.3%

Schizophrenia and Other Psychotic Disorders 3 1,738 0.9%

Alcohol Use Disorder 4 857 0.5%

Bipolar Disorder 1 3 0.002%

Traumatic Brain Injury 0 - -

“None or Unknown” 8 138,467 74.8%

16.0%

4.3%

2.0%

1.6%

1.3%

0.9%

0.5%

0.0%

0.0%

0% 5% 10% 15% 20% 25%

Other Condition

Dementia

Depression

Substance Use Disorder

Anxiety

Schizophrenia/Other Psychotic Disorders

Alcohol Use Disorder

Bipolar Disorder

Traumatic Brain Injury
NAMRS FFY 2016 Report: Case Component 32

CL-18B CLIENTS – MULTIPLE BEHAVIORAL HEALTH CONDITIONS

“Exhibit CL-18b Clients – Multiple Behavioral Health Conditions” indicates the number of clients 

with multiple behavioral health conditions. Most client records, 74.8%, listed no condition and 

23.9% indicated only one condition. 

Exhibit CL-18b Clients – Multiple Behavioral Health Conditions

Clients with Multiple Conditions # of states # of clients % of clients (185,096)

No Condition 8 138,467 74.8%

Only 1 Condition 8 44,146 23.9%

2 Conditions 5 2,185 1.2%

3 or More Conditions 5 298 0.2%

CL-19 CLIENTS – LIVING SETTINGS AT START AND CLOSE

NAMRS requests information about clients’ primary living setting at the start of the investigation 

and close of the investigation. Five states reported the client’s living setting at both the start and 

close of the investigation (73,631 client records) and the data are displayed in “Exhibit CL-19

Clients – Living Settings at Start and Close.” There were 45,301 records including setting at start 

of the investigation and 49,315 at the close of the investigation. Half of the clients, 50%, lived in 

their residence or residence of a relative or caregiver at both the start and close of the investigation. 

A living setting was not included for 33% of client records. Reasons for Unknown values for the 

living setting may include: recorded as Unknown in state reporting system; and data records 

submitted to NAMRS did not contain the information, presumably because the information was 

not collected. It is important to note that the living setting at the start may not be the same location 

as the maltreatment setting. For example, the client may live in their own residence but, the 

maltreatment may have occurred at an Adult Day Services Center.

Exhibit CL-19 Clients – Living Setting at Start and Close

Categories less than one percent are not Unknown not shown above.

0% 10% 20% 30% 40% 50% 60%

Residence of Client, Relative, or Caregiver

Nursing Home (Non-Specific)

Other

Residential Care Community (Non-Specific)

Licensed Residential Care Community

Licensed Nursing Home

at Start

at Close
NAMRS FFY 2016 Report: Case Component 33

Living Setting Start 

counts

% of 

clients 

(73,631)

Close 

counts

% of 

clients 

(73,631)

Residence of Client, Relative, or Caregiver 39,687 53.9% 36,788 50.0%

Nursing Home (Non-Specific) 2,505 3.4% 3,114 4.2%

Other Setting 1,126 1.5% 5,921 8.0%

Residential Care Community (Non-Specific) 896 1.2% 808 1.1%

Licensed Residential Care Community 716 1.0% 1,725 2.3%

Licensed Nursing Home 352 0.5% 914 1.2%

Non-Licensed Residential Care Community 19 0.03% 45 0.1%

Non-Licensed Nursing Home - - - -

Unknown 28,330 38.5% 24,316 33.0%

CL-20A CLIENTS – SUBSTITUTE DECISION MAKERS AT START AND CLOSE

NAMRS requests information about clients’ substitute decision makers at the start and close of the 

investigation. It includes authorizations that are in effect and related to health, personal, or 

financial decision making for the client. Multiple substitute decision maker code values can be 

submitted for the client. There are six data elements defining substitute decision maker and an 

option for None/Unknown. Two states reported information about substitute decision makers at 

both start and close (19,606 client records). There were 280 records that included at least one 

decision maker at the start of the investigation and 352 records that included at least one decision 

maker at the close of the investigation. “Exhibit CL-20a Clients – Substitute Decision Makers at 

Start and Close” displays the top substitute decision maker as Guardianship or Conservatorship of 

Person. 

Exhibit CL-20a Clients – Substitute Decision Makers at Start and Close

Categories less than 0.1% and Unknown not shown above.

0.0% 0.5% 1.0% 1.5% 2.0%

Guardianship or Conservatorship of Person

Representative Payee

Guardianship or Conservatorship of Property

Guardianship/Conservatorship (Non-Specific)

at Start

at Close
NAMRS FFY 2016 Report: Case Component 34

Substitute Decision Maker Start 

counts

% of 

clients 

(19,606)

Close 

counts

% of 

clients 

(19,606)

Guardianship or Conservatorship of Person 216 1.1% 279 1.4%

Representative Payee 43 0.2% 51 0.3%

Guardianship or Conservatorship of Property 13 0.1% 16 0.1%

Guardianship/Conservatorship (Non-Specific) 8 0.04% 10 0.1%

Health Care Proxy in Effect - - - -

Financial Proxy in Effect - - - -

Unknown 19,328 98.6% 19,254 98.2%

CL-20B CLIENTS – MULTIPLE SUBSTITUTE DECISION MAKERS AT START AND CLOSE

“Exhibit CL-20b Clients – Multiple Substitute Decision Makers at Start and Close” indicates the 

number of clients with multiple substitute decision makers at start and close. Most client records, 

98.2%, indicated no substitute decision maker.

Exhibit CL-20b Clients – Multiple Substitute Decision Makers at Start and Close

Clients with Multiple Substitute 

Decision Makers

Start 

counts

% of 

clients 

(19,606)

Close 

counts

% of 

clients 

(19,606)

No Substitute Decision Maker 19,328 98.6% 19,254 98.2%

Only 1 Substitute Decision Maker 276 1.4% 348 1.8%

2 or More Substitute Decision 

Makers 2 0.01% 4 0.02%

CL-21A CLIENTS – SERVICES AT START

NAMRS requests client services data in four distinct ways – start and close of investigation, 

provided by APS, and referred for services. “Exhibit CL-21a Clients – Services at Start” includes 

the services known to the agency that the client was already receiving at the start of the 

investigation. Four states provided client services information at the start of the investigation

(63,348 client records submitted of which 25,113 contained at least one service).
NAMRS FFY 2016 Report: Case Component 35

Exhibit CL-21a Clients – Services at Start

Categories less than one percent and “None or Unknown” not shown above.

Services at Start

# of states 

that 

submitted

Count

% of 

clients 

(63,348)

Victim Services 2 9,829 15.5%

Care/Case Management Services 2 8,386 13.2%

Other Services 4 7,286 11.5%

Nutrition 3 1,066 1.7%

In-Home Assistance Services 3 694 1.1%

Housing and Relocation Services 1 402 0.6%

Medical and Dental Services 2 199 0.3%

Legal Services 2 154 0.2%

Transportation 1 77 0.1%

Caregiver Support Services 3 63 0.1%

Community Day Services 1 16 0.03%

Education, Employment, And Training 

Services 0 - -

Emergency Assist/Material Aid Services 0 - -

Financial Planning Services 0 - -

Medical Rehabilitation Services 0 - -

Mental Health Services 0 - -

Public Assistance Benefits 0 - -

Substance Use Services 0 - -

“None or Unknown” 4 38,235 60.4%

15.5%

13.2%

11.5%

1.7%

1.1%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Victim Services

Care/Case Management Services

Other Services

Nutrition

In-Home Assistance Services
NAMRS FFY 2016 Report: Case Component 36

CL-21B CLIENTS – MULTIPLE SERVICES AT START

Multiple service code values can be submitted for the client. “Exhibit CL-21b Clients – Multiple 

Services at Start” indicates the number of clients that had services at the start of the investigation.

Most client records, 60.3%, did not include a service and 35.8% indicated only one service was

received. 

Exhibit CL-21b Clients – Multiple Services at Start

Clients with Multiple Services # of states # of clients % of clients (63,348)

No Service 4 38,235 60.3%

Only 1 Service 4 22,696 35.8%

2 Services 4 1,878 3.0%

3 or More Services 2 539 0.9%

CL-22A CLIENTS – SERVICES PROVIDED BY APS

NAMRS requests client services data in four distinct ways – start and close of investigation, 

provided by APS, and referred for services. “Exhibit CL-22a Clients – Services Provided by APS”

includes the services that the agency provided on behalf of the client during the investigation or 

while the agency kept an open case. Five states reported data regarding services provided by APS

(81,009 client records submitted, of which 18,983 included at least one service). 

Exhibit CL-22a Clients – Services Provided by APS

Categories less than 2% and “None or Unknown” not shown above.

12.4%

6.2%

4.2%

3.1%

2.6%

2.5%

2.0%

2.0%

0% 2% 4% 6% 8% 10% 12% 14%

Victim Services

Care/Case Management Services

In-Home Assistance Services

Legal Services

Mental Health Services

Housing and Relocation Services

Financial Planning Services

Other Services
NAMRS FFY 2016 Report: Case Component 37

Services Provided by APS

# of states 

that 

submitted

Count % of clients 

(81,009)

Victim Services 2 10,020 12.4%

Care/Case Management Services 3 5,043 6.2%

In-Home Assistance Services 5 3,433 4.2%

Legal Services 4 2,485 3.1%

Mental Health Services 2 2,068 2.6%

Housing and Relocation Services 3 2,014 2.5%

Financial Planning Services 1 1,637 2.0%

Other Services 4 1,607 2.0%

Nutrition 4 1,336 1.6%

Public Assistance Benefits 3 1,219 1.5%

Emergency Assist/Material Aid Services 1 1,028 1.3%

Medical and Dental Services 3 887 1.1%

Transportation 2 115 0.1%

Caregiver Support Services 2 89 0.1%

Community Day Services 3 68 0.1%

Substance Use Services 1 34 0.04%

Medical Rehabilitation Services 1 1 0.01%

Education, Employment, And Training 

Services 0 - -

“None or Unknown” 5 62,026 76.6%

CL-22B CLIENTS – MULTIPLE SERVICES PROVIDED BY APS

Multiple service code values can be submitted for the client. “Exhibit CL-22b Clients – Multiple 

Services Provided by APS” indicates the number of clients that received services provided by APS 

during the investigation. Most client records, 76.6%, did not include a service and 15.1% indicated 

only one service received. 

Exhibit CL-22b Clients – Multiple Services Provided by APS

Clients with Multiple Services # of states # of clients % of clients (81,009)

No Service 5 62,026 76.6%

Only 1 Service 5 12,190 15.1%

2 Services 4 3,091 3.8%

3 Services 4 1,739 2.2%

4 Services 4 975 1.2%

5 Services 2 543 0.7%

6 or More Services 2 445 0.6%
NAMRS FFY 2016 Report: Case Component 38

CL-23A CLIENTS – SERVICES REFERRED

NAMRS requests client services data in four distinct ways – start and close of investigation, 

provided by APS, and referred for services. “Exhibit CL-23a Clients – Services Referred” shows

the services for which the agency referred the client. Six states provided data about referrals for 

services for clients (67,580 client records submitted of which 31,476 included at least one service).

The most commonly chosen response was Other Services with 31.9% of records. Some examples 

of Other Services include burial/cremation, Alzheimer's/dementia education, public health, animal 

control, and consultation.

Exhibit CL-23a Clients – Services Referred

Categories less than 2% and “None or Unknown” not shown above.

31.9%

5.5%

3.3%

3.1%

3.0%

2.5%

2.3%

0% 5% 10% 15% 20% 25% 30% 35%

Other Services

Care/Case Management Services

Emergency Assist/Material Aid Services

Legal Services

In-Home Assistance Services

Housing and Relocation Services

Medical and Dental Services
NAMRS FFY 2016 Report: Case Component 39

Services Referred # of states submitting Count % of clients (67,580)

Other Services 5 21,560 31.9%

Care/Case Management Services 3 3,748 5.5%

Emergency Assist/Material Aid Services 3 2,214 3.3%

Legal Services 5 2,100 3.1%

In-Home Assistance Services 5 2,026 3.0%

Housing and Relocation Services 4 1,691 2.5%

Medical and Dental Services 3 1,546 2.3%

Mental Health Services 5 1,010 1.5%

Victim Services 3 841 1.2%

Public Assistance Benefits 4 689 1.0%

Community Day Services 3 596 0.9%

Caregiver Support Services 3 549 0.8%

Transportation 3 245 0.4%

Medical Rehabilitation Services 3 203 0.3%

Financial Planning Services 3 117 0.2%

Substance Use Services 3 114 0.2%

Nutrition 3 58 0.1%

Education, Employment, and Training 

Services 2 9 0.01%

“None or Unknown” 6 36,104 53.4%

CL-23B CLIENTS – MULTIPLE SERVICES REFERRED

Multiple service code values can be submitted for the client. “Exhibit CL-23b Clients – Multiple 

Services Referred” indicates the number of clients that APS referred to received services. Most 

client records, 53.4%, did not include a service and 39.6% indicated only one service. 

Exhibit CL-23b Clients – Multiple Services Referred

Clients with Multiple Services # of states # of clients % of clients (67,580)

No Service 6 36,104 53.4%

Only 1 Service 6 26,745 39.6%

2 Services 6 2,745 4.1%

3 Services 4 1,230 1.8%

4 Services 4 466 0.7%

5 or More Services 4 267 0.4%
NAMRS FFY 2016 Report: Case Component 40

CL-24A CLIENTS – SERVICES AT CLOSE

NAMRS requests client services data in four distinct ways – start and close of investigation, 

provided by APS, and referred for services. “Exhibit CL-24a Client – Services at Close” includes 

the services known to the agency that the client was receiving at the time of case closure. Four 

states provided information about clients’ services at case closure (66,326 records submitted, of 

which 16,462 included at least one service).

Exhibit CL-24a Clients – Services at Close

Categories less than 2% and “None or Unknown” not shown above.

Services at Close # of states 

submitting Count % of clients (66,326)

Victim Services 3 9,279 14.0%

In-Home Assistance Services 4 3,413 5.1%

Legal Services 3 2,424 3.7%

Care/Case Management Services 3 2,384 3.6%

Emergency Assist/Material Aid Services 2 2,042 3.1%

Housing and Relocation Services 2 1,840 2.8%

Mental Health Services 2 1,721 2.6%

Financial Planning Services 2 1,486 2.2%

Nutrition 4 1,225 1.8%

Other Services 4 1,191 1.8%

Public Assistance Benefits 3 752 1.1%

Caregiver Support Services 3 432 0.7%

Transportation 3 170 0.3%

Medical and Dental Services 1 159 0.2%

Community Day Services 3 77 0.1%

Medical Rehabilitation Services 2 57 0.1%

Substance Use Services 2 30 0.05%

Education, Employment, and Training Services 0 - -

“None or Unknown” 4 49,864 75.2%

14.0%

5.1%

3.7%

3.6%

3.1%

2.8%

2.6%

2.2%

0% 2% 4% 6% 8% 10% 12% 14% 16%

Victim Services

In-Home Assistance Services

Legal Services

Care/Case Management Services

Emergency Assist/Material Aid Services

Housing and Relocation Services

Mental Health Services

Financial Planning Services
NAMRS FFY 2016 Report: Case Component 41

CL-24B CLIENTS – MULTIPLE SERVICES AT CLOSE

Multiple service code values can be submitted for the client. “Exhibit CL-24b Clients – Multiple 

Services at Close” indicates the number of services known to the agency that the client was 

receiving at the time of case closure. Most client records, 75.2%, did not include a service and 

14.7% indicated only one service. 

Exhibit CL-24b Clients – Multiple Services at Close

Clients with Multiple Services # of states # of clients % of clients 

(66,326)

No Service 4 49,864 75.2%

Only 1 Service 4 9,769 14.7%

2 Services 4 3,560 5.4%

3 Services 3 1,684 2.5%

4 or More Services 3 1,449 2.2%

CL-25A CLIENTS – INTERAGENCY COORDINATION

Five states provided data about interagency coordination activities for clients as noted in “Exhibit 

CL-25a Clients – Interagency Coordination” (63,229 client records submitted, of which 9,194 

included at least one interagency coordination). The interagency coordination data elements are 

Law Enforcement or Prosecutorial Offices, Protection and Advocacy or Client Advocacy Program, 

State Licensing Agency, State Medicaid Fraud Control Unit, Long-Term Care Ombudsman 

Program, Other, and None. The interagency coordination data element was included in 15.1% of 

the records submitted.

Exhibit CL-25a Clients – Interagency Coordination

Categories less than 0.1% and Unknown not shown above.

9.4%

4.6%

0.7%

0.3%

0.1%

0% 2% 4% 6% 8% 10% 12%

Other Agency

Law Enforcement or Prosecutorial Offices

State Licensing Agency

State Medicaid Fraud Control Unit (MFCU)

Long Term Care Ombudsman Program
NAMRS FFY 2016 Report: Case Component 42

Interagency Coordination # of states 

submitting Count % of clients (63,229)

Other Agency 3 5,957 9.4%

Law Enforcement or Prosecutorial Offices 5 2,934 4.6%

State Licensing Agency 4 422 0.7%

State Medicaid Fraud Control Unit (MFCU) 1 172 0.3%

Long Term Care Ombudsman Program 3 78 0.1%

Protection/Advocacy/Client Advocacy Program (CAP) 1 6 0.01%

Unknown 8 54,035 85.5%

CL-25B CLIENTS – MULTIPLE INTERAGENCY COORDINATION

Multiple interagency coordinations can be submitted for each client. “Exhibit CL-25b Clients –

Multiple Interagency Coordination” indicates the number of coordinations for clients. Most client 

records, 85.5%, did not include a coordination and 14.2% indicated one coordination. 

Exhibit CL-25b Clients – Multiple Interagency Coordination

Clients with Multiple Coordinations # of states # of clients % of clients (63,229)

No Coordination 5 54,035 85.5%

Only 1 Coordination 5 9,007 14.2%

2 Coordinations 2 65 0.1%

3 Coordinations 1 56 0.1%

4 or More Coordinations 2 66 0.1%

CL-26A CLIENTS – PREVIOUS REPORTS

Fifteen states reported on clients’ previous reports of maltreatment and the data are displayed in 

“Exhibit CL-26a Clients – Previous Reports” (284,656 client records submitted, of which 243,699 

included veteran status). Fourteen states reported 54.2% of the records submitted contained the No 

Previous Reports data element while 12 states indicated 31.4% of clients had previous reports of 

maltreatment. Fifteen states reported 14.4% of the client records reported Unknown. Reasons for 

Unknown values may include: recorded as Unknown in state reporting system or staff were not 

able to determine; and data records submitted to NAMRS did not contain the information, 

presumably because the information was not collected.

Exhibit CL-26a Clients – Previous Reports

Yes, 31.4%

No, 54.2%

Unknown, ...
NAMRS FFY 2016 Report: Case Component 43

Previous Reports # of states submitting Count % of clients (284,656)

Yes 12 89,372 31.4%

No 14 154,327 54.2%

Unknown 15 40,957 14.4%

CL-26B VICTIMS – PREVIOUS REPORTS BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit CL-26b Victims – Previous Reports by Substantiated Maltreatment Type” depicts 

information from eight states (77,651 victims represented). An additional one state’s records were 

excluded from this cross tabulation due to too much missing data (more than 25%). Previous APS 

reports were noted most frequently for victims of Abandonment at 61.7%, Self-Neglect at 48.5%,

and Other Type at 47.3%.

Exhibit CL-26b Victims – Previous Reports by Substantiated Maltreatment Type

No Previous Report and Unknown categories not shown above.

Previous Reports All VictimsAbandonmentEmotional AbuseExploitationNeglectPhysical AbuseSexual 

Abuse

Self-NeglectOther Type

Previous Report(s) 46.1% 61.7% 31.1% 36.7% 39.0% 34.5% 31.4% 48.5% 47.3%

No Previous Report 53.9% 38.3% 68.9% 63.4% 61.0% 65.5% 68.6% 51.5% 52.7%

Total 77,651 736 3,824 5,075 6,019 3,686 204 61,942 3,517

0% 10% 20% 30% 40% 50% 60% 70%

Abandonment

Emotional abuse

Exploitation

Neglect

Physical Abuse

Sexual Abuse

Self-Neglect

Other Type

Previous Report(s)
NAMRS FFY 2016 Report: Case Component 44

CASE COMPONENT – MALTREATMENT ALLEGATIONS

MA-1 MALTREATMENT ALLEGATION RECORD SUBMISSION

“Exhibit MA-1 Maltreatment Allegation Record Submission” displays information about the 

maltreatment type and disposition type associated with each record submitted. Twenty-four states 

submitted maltreatment allegation records (454,033 records submitted). The NAMRS business 

rule associated with these two data elements requires that a record have both maltreatment and 

disposition types. Therefore, 100% of cases included both data elements.

Exhibit MA-1 Maltreatment Allegation Record Submission

Data Element

# of states 

that 

submitted

# of records 

from states

# of records 

with data

% of records 

from states 

with data

% of total 

records 

(454,033)

Maltreatment Type 24 454,033 454,033 100.0% 100.0%

Disposition Type 24 454,033 454,033 100.0% 100.0%

MA-2 MALTREATMENT ALLEGATION – TYPES AND DISPOSITIONS

The maltreatment allegation types, displayed in “Exhibit MA-2 Maltreatment Allegation – Types 

and Dispositions” are Abandonment, Emotional Abuse, Exploitation (Non-Specific), Financial 

Exploitation, Neglect, Physical Abuse, Sexual Abuse, Self-Neglect, Other Exploitation, and Other.

NAMRS requires that each case have a maltreatment type; therefore, all 24 reporting states had a 

maltreatment type identified for each record. The top three maltreatment types were Self-Neglect, 

Neglect, and Financial Exploitation.

Exhibit MA-2 Maltreatment Allegation – Types and Dispositions

Maltreatment Types Total Substantiated Inconclusive Unsubstantiated Other

Abandonment 2,505 34.89% 11.78% 52.97% 0.36%

Emotional Abuse 42,520 14.34% 19.11% 49.37% 17.18%

Financial Exploitation 47,782 14.58% 22.67% 56.65% 6.10%

Exploitation (NonSpecific) 19,198 14.42% 3.84% 45.06% 36.68%

Other Exploitation 5,781 22.42% 9.79% 63.35% 4.45%

Neglect 85,701 13.17% 10.04% 59.92% 16.86%

Physical Abuse 47,260 13.82% 18.03% 56.59% 11.56%

Sexual Abuse 5,380 11.04% 22.01% 53.14% 13.81%

Self-Neglect 180,658 44.00% 6.16% 27.60% 22.24%

Other 17,248 37.93% 17.12% 35.01% 9.94%

All Maltreatments 454,033 26.97% 11.66% 43.73% 17.64%
NAMRS FFY 2016 Report: Case Component 45

MA-3 MALTREATMENT ALLEGATION – MULTIPLE SUBSTANTIATION

“Exhibit MA-3 Maltreatment Allegation – Multiple Substantiation” displays the data regarding 

multiple maltreatment allegation substantiations. Twenty-four states submitted data (340,384 

clients represented). There were no allegations of maltreatment substantiated for 67.6% of clients, 

while 29.4% of clients had one maltreatment substantiated. There were multiple substantiations 

for three percent of victims.

Exhibit MA-3 Maltreatment Allegation – Multiple Substantiation

Substantiation Count % of clients 

(340,384)

Clients with Substantiation Criteria Unmet 229,957 67.6%

Victims with 1 Substantiation 100,227 29.4%

Victims with 2 Substantiations 8,627 2.5%

Victims with 3 or More Substantiations 1,573 0.5%
NAMRS FFY 2016 Report: Case Component 46

CASE COMPONENT – PERPETRATORS

PR-1 PERPETRATOR RECORD SUBMISSION

“Exhibit PR-1 Perpetrator Record Submission” provides an overview of the 21 states that provided

perpetrator information (93,477 perpetrator records submitted). Some states record self-neglecters 

as being both the client and the perpetrator; however, this practice is far from universal. For all 

perpetrator exhibits, data are not presented for Self-Neglect. The NAMRS business rules require 

that substantiated maltreatment records have a unique perpetrator identification number if states 

collect perpetrator information. Seven of the 21 states identify all victims of Self-Neglect as the 

perpetrator. It was determined that the best approach for sharing perpetrator information was to 

exclude the Self-Neglect data element from a record were the victim of Self-Neglect was identified 

as the perpetrator. If the client had multiple maltreatments, then only the Self-Neglect maltreatment 

was excluded from the perpetrator data exhibits.

Perpetrator age was included in 73.2% of records submitted, while 87.2% reported the 

perpetrators’ gender. Race was recorded for 67.8% of the perpetrators.

Exhibit PR-1 Perpetrator Record Submission

Data Element # of states 

submitting

# of records 

from states

# of records 

with data

% of records 

from states 

with data

% of total 

records 

(93,477)

Perpetrator ID 21 32,378 32,378 100.0% 100.0%

Gender Identity 20 32,163 28,059 87.2% 86.7%

Age 17 26,769 19,604 73.2% 60.5%

Race 16 29,692 20,140 67.8% 62.2%

Ethnicity 13 23,920 10,969 45.9% 33.9%

Disabilities 4 11,856 6,157 51.9% 19.0%

Behavioral Health 

Screenings 4 9,183 1,999 21.8% 6.2%

PR-2A PERPETRATORS – AGE GROUP

Perpetrator age, shown in “Exhibit PR-2a Perpetrators – Age Group,” was reported by 17 states

(26,769 perpetrators represented). These data, for Perpetrator Age Group, do not include victims 

with a substantiation of Self-Neglect. The age of the perpetrator is determined at the start of the 

investigation. Perpetrator ages were categorized in the same groups as those used during Key 

Indicator Component data submission. As with Key Indicator Component age data, comparisons 

between categories must take into account the number of perpetrators per year represented (i.e., 

average number of perpetrators per year of age). The top age grouping for perpetrators was 

Unknown at 26.8%. The highest known age group of perpetrators was within the 50-59 age group.
NAMRS FFY 2016 Report: Case Component 47

Exhibit PR-2a Perpetrators – Age Group

Unknown not shown above.

Age Group # of states submitting Count % of perpetrators (26,769)

Age 17 or Younger 6 1,410 5.3%

Age 18-29 16 2,473 9.2%

Age 30-39 16 2,698 10.1%

Age 40-49 16 3,237 12.1%

Age 50-59 17 4,072 15.2%

Age 60-69 17 2,577 9.6%

Age 70-74 15 910 3.4%

Age 75-84 14 1,406 5.3%

Age 85+ 12 821 3.1%

Unknown 14 7,165 26.8%

PR-2B PERPETRATORS – AGE GROUP BY SUBSTANTIATED MALTREATMENT TYPE

Nine states’ data are represented in “Exhibit PR-2b Perpetrators – Age Group by Substantiated 

Maltreatment Type” (18,946 perpetrators represented). An additional seven states’ records were 

excluded from this cross tabulation due to too much missing data (more than 25%). The 

maltreatment type Self-Neglect is not included in Exhibit PR-2b. Perpetrators of Physical Abuse

and Sexual Abuse were most commonly in the 29 or younger age range, then in the 50-59 age 

range. Abandonment was typically perpetrated by older individuals and relatively rarely by 

younger individuals. By contrast, Exploitation was typically perpetrated by younger to middleaged individuals. Other abuse was most frequently perpetrated by individuals in the 70 years and 

older age range.

5.3%

9.2%

10.1%

12.1%

15.2%

9.6%

3.4%

5.3%

3.1%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Age 17 or Younger

Age 18-29

Age 30-39

Age 40-49

Age 50-59

Age 60-69

Age 70-74

Age 75-84

Age 85+
NAMRS FFY 2016 Report: Case Component 48

Exhibit PR-2b Perpetrators – Age Group by Substantiated Maltreatment Type Age All Substantiated Perpetrators Abandonment Emotional 

AbuseExploitationNeglectPhysical AbuseSexual 

Abuse

Other Type

29 or Younger 19.7% 5.8% 22.3% 19.0% 16.8% 28.0% 27.4% 15.1%

30-39 13.6% 9.9% 15.7% 19.8% 12.7% 15.3% 10.5% 6.4%

40-49 16.2% 12.6% 17.2% 23.0% 18.1% 15.6% 15.8% 7.5%

50-59 20.7% 28.8% 21.1% 21.6% 24.8% 18.4% 24.2% 14.9%

60-69 13.1% 24.2% 10.9% 9.3% 14.7% 9.1% 10.0% 18.3%

70+ 16.0% 18.8% 11.2% 6.3% 12.1% 12.5% 11.1% 37.7%

Unknown 0.8% - 1.5% 1.0% 1.0% 1.2% 1.1% 0.1%

Total 18,946 757 3,399 4,805 5,677 3,574 190 3,535

PR-3A PERPETRATORS – GENDER IDENTITY

“Exhibit PR-3a Perpetrators – Gender Identity” reflects perpetrator gender identity data reported 

by 20 states(32,163 records submitted, of which 28,059, or 87.2% included gender identity). These 

data, for the gender identity of perpetrators, do not include victims with a substantiation of SelfNeglect. The majority of perpetrators, 47.1%, were female, and 40.2% were male. No state 

reported perpetrator transgender identity. 

Exhibit PR-3a Perpetrators – Gender Identity

Transgender not shown above.

Perpetrators by Gender Identity # of states submitting Count % of perpetrators 

(32,163)

Male 20 12,925 40.2%

Female 20 15,134 47.1%

Transgender 0 - -

Unknown 19 4,104 12.8%

Male

40.2%

Female

47.1%

Unknown

12.8%
NAMRS FFY 2016 Report: Case Component 49

PR-3B PERPETRATORS – GENDER IDENTITY BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit PR-3b Perpetrators – Gender Identity by Substantiated Maltreatment Type” was obtained 

using data from 14 states (23,976 perpetrators represented). An additional five states’ records were 

excluded from this cross tabulation due to too much missing data (more than 25%). The 

maltreatment type Self-Neglect is not included in Exhibit PR-3b. Perpetrators in cases of Sexual 

Abuse were almost all male, with most perpetrators of Physical Abuse and Emotional Abuse also 

being male. Perpetrators of Neglect, Exploitation, and other abuse were mostly female.

Exhibit PR-3b Perpetrators – Gender Identity by Substantiated Maltreatment Type

Unknown and Transgender not shown above.

Gender 

Identity

All 

Substantiated 

Perpetrators

Abandonment Emotional 

Abuse Exploitation Neglect Physical Abuse

Sexual 

Abuse

Other 

Type

Male 45.0% 48.8% 56.4% 40.4% 41.0% 56.8% 84.4% 37.7%

Female 52.4% 51.2% 42.5% 55.6% 56.1% 41.2% 11.1% 61.2%

Transgender - - - - - - - -

Unknown 2.7% - 1.1% 4.0% 2.9% 2.0% 4.4% 1.1%

Total 23,976 801 4,423 6,686 8,216 4,267 270 3,589

PR-4A PERPETRATORS – RACE

Sixteen states submitted data on perpetrator race (29,692 perpetrator records submitted, of which 

20,140 included at least one race). These data, for the race of perpetrators, do not include victims 

with a substantiation of Self-Neglect. According to the FFY2016 data reported on perpetrators’ 

race, the greatest number of perpetrators self-identify as being White at 47.3%. States are permitted 

to report multiple races for one individual. 

Reasons for Unknown values may include: race was recorded as Unknown in state reporting 

system because the perpetrator did not know or disclose their race or staff were not able to 

determine their race; and data records submitted to NAMRS did not contain race information, 

presumably because the information was not collected.

0% 10% 20% 30% 40% 50% 60% 70% 80%

Abandonment

Emotional Abuse

Exploitation

Neglect

Physical Abuse

Sexual Abuse

Other Type

Male

Femal

e
NAMRS FFY 2016 Report: Case Component 50

Exhibit PR-4a Perpetrators – Race

Race # of states 

submitting Count % of perpetrators (29,692)

White 16 14,048 47.3%

Black or African American 14 3,921 13.2%

Other Race 8 1,883 6.3%

American Indian or Alaska Native 12 157 0.5%

Asian 10 114 0.4%

Native Hawaiian or Other Pacific Islander 9 102 0.3%

Unknown 16 9,552 32.2%

PR-4B PERPETRATORS – MULTIPLE RACES

“Exhibit PR-4b Perpetrators – Multiple Races” indicates the number of perpetrators with multiple 

races. These data, for the multiple races of perpetrators, do not include victims with a substantiation 

of Self-Neglect. Most perpetrator records, 67.5%, listed only one race and 32.2% did not include 

a race.

Exhibit PR-4b Perpetrators – Multiple Races

Perpetrators with Multiple Races # of states # of 

perpetrators

% of 

perpetrators 

(29,692)

No Race 16 9,552 32.2%

Only 1 Race 16 20,056 67.5%

2 or More Races 6 84 0.3%

PR-5 PERPETRATORS – ETHNICITY

“Exhibit PR-5 Perpetrators – Ethnicity,” shows the perpetrators’ ethnicity, as reported by 12 states

(23,920 perpetrator records submitted). These data, for the ethnicity of perpetrators, do not include 

victims with a substantiation of Self-Neglect. Of these perpetrators, 39.3% were not Hispanic, 

Latino/a, or Spanish. Additionally, 6.5% were classified as Hispanic, Latino/a, or Spanish and the 

ethnicity of 54.1% of the perpetrators was unknown. Unknown may be reported because of several 

reasons, including: state collected race and ethnicity as a single data element, so only the 

47.3%

13.2%

6.3%

0.5%

0.4%

0.3%

32.2%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

White

Black or African American

Other Race

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Unknown
NAMRS FFY 2016 Report: Case Component 51

perpetrator’s race was recorded; state reporting system collects Unknown ethnicity because the 

perpetrator did not know or disclose their ethnicity or staff were not able to determine perpetrator 

ethnicity; and data record submitted to NAMRS did not contain the ethnicity information 

presumably because the information was not collected.

Exhibit PR-5 Perpetrators – Ethnicity

Ethnicity # of states submitting Count % of perpetrators 

(23,920)

Hispanic, Latino/a, or Spanish 11 1,561 6.5%

Not Hispanic, Latino/a, or Spanish 10 9,408 39.3%

Unknown 13 12,951 54.1%

PR-6A PERPETRATORS – RACE/ETHNICITY

The majority of perpetrators were white, as shown in “Exhibit PR-6a Perpetrators –

Race/Ethnicity.” These data, for the race/ethnicity of perpetrators, do not include victims with a 

substantiation of Self-Neglect. Nine states submitted race/ethnicity data (29,692 perpetrator 

records submitted).

Exhibit PR-6a Perpetrators – Race/Ethnicity

Categories less than one percent and Unknown not shown above.

Hispanic

6.5%

Not Hispanic

Unknown 39.3%

54.1%

42.9%

13.0%

5.3%

6.1%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

White

Black/African American

Hispanic/Latino

Other (Non-Hispanic)
NAMRS FFY 2016 Report: Case Component 52

Race/Ethnicity # of states 

submitting Count % of perpetrators (29,692)

White 16 12,743 42.9%

Black/African American 14 3,859 13.0%

Hispanic/Latino 11 1,561 5.3%

Other (Non-Hispanic) 7 1,805 6.1%

American Indian/Alaska Native 9 129 0.4%

Asian 9 106 0.4%

Native Hawaiian/Other Pacific Islander 7 96 0.3%

Multiple Races (Non-Hispanic) 6 79 0.3%

Unknown 16 9,314 31.4%

PR-6B PERPETRATORS– RACE/ETHNICITY BY SUBSTANTIATED MALTREATMENT TYPE

“Exhibit PR-6b Perpetrators – Race/Ethnicity by Substantiated Maltreatment Type” was compiled 

using combined race and ethnicity data from eight states (18,547 perpetrators represented). The 

maltreatment type Self-Neglect is not included in Exhibit PR-6b. An additional seven states’ 

records were excluded from this cross tabulation due to too much missing data (more than 25%).

Exhibit PR-6b Perpetrators – Race/Ethnicity by Substantiated Maltreatment Type

Race/Ethnicity

All 

Substantiated 

Perpetrators

Abandonment Emotional 

Abuse Exploitation Neglect Physical Abuse

Sexual 

Abuse

Other 

Type

White 54.1% 65.9% 53.4% 51.7% 46.8% 51.4% 42.2% 71.7%

Black/African 

American 17.6% 18.4% 14.7% 17.3% 21.4% 17.4% 20.6% 13.3%

Hispanic/Latino 7.5% 0.9% 7.3% 6.1% 9.3% 12.2% 5.0% 0.8%

Other (nonHispanic) 9.1% 10.6% 10.6% 10.9% 10.5% 5.9% 9.4% 9.4%

American 

Indian/ Alaska 

Native

0.2% 0.1% 0.4% 0.3% 0.2% 0.1% - 0.1%

Asian 0.4% 0.3% 0.4% 0.3% 0.6% 0.4% 0.6% 0.4%

Native 

Hawaiian/ 

Other PI

0.5% - 0.9% 0.4% 0.7% 0.6% 1.1% -

Multiple Races 

(non-Hispanic) 0.4% 0.3% 0.3% 0.4% 0.5% 0.6% - 0.1%

Unknown 10.1% 3.6% 12.0% 12.7% 10.0% 11.4% 21.1% 4.3%

Total 18,547 757 3,665 4,896 5,878 3,440 180 3,107
NAMRS FFY 2016 Report: Case Component 53

PR-7A PERPETRATORS – DISABILITIES

Four states reported data on one or more perpetrator disabilities (11,856 perpetrator records 

submitted, of which 6,157 included at least one disability) of the perpetrators identified within 

those states, as displayed in “Exhibit PR-7a Perpetrators – Disabilities.” These data, for

perpetrators with disabilities, do not include victims with a substantiation of Self-Neglect. These 

disabilities include perpetrators’ physical, emotional, and mental health issues that result in a 

limitation in activities and restrictions to fully participate at school, work, or in the community. 

The three highest reported difficulties experienced by perpetrators were Vision, Ambulatory, and 

Cognitive. “None or Unknown” disabilities data of 48.1% include: Unknown in state reporting 

system or staff were not able to determine; and data records submitted to NAMRS did not contain 

the information, presumably because the information was not collected.

Exhibit PR-7a Perpetrators – Disabilities

“None or Unknown” not shown above.

Disability # of states that 

submitted Count % of perpetrators (11,856)

Vision 3 2,955 24.9%

Ambulatory 2 2,045 17.2%

Cognitive 4 1,928 16.3%

Communication 2 511 4.3%

Hearing 3 404 3.4%

Other Difficulty 2 128 1.1%

Independent Living 1 11 0.1%

Self-Care 1 7 0.1%

“None or Unknown” 4 5,699 48.1%

PR-7B PERPETRATORS – MULTIPLE DISABILITIES

“Exhibit PR-7b Perpetrators – Multiple Disabilities” indicates the number of perpetrators with

multiple disabilities. These data, for perpetrators with multiple disabilities, do not include victims 

with a substantiation of Self-Neglect. A disability was not included in 48.1% of perpetrator records 

and 40.2% indicated only one disability.

24.9%

17.2%

16.3%

4.3%

3.4%

1.1%

0.1%

0.1%

0% 5% 10% 15% 20% 25% 30%

Vision

Ambulatory

Cognitive

Communication

Hearing

Other Difficulty

Independent Living

Self-Care
NAMRS FFY 2016 Report: Case Component 54

Exhibit PR-7b Perpetrators – Multiple Disabilities

Perpetrators with Multiple 

Disabilities # of states # of perpetrators

% of 

perpetrators 

(11,856)

No Disability 4 5,699 48.1%

Only 1 Disability 4 4,762 40.2%

2 Disabilities 3 1,036 8.7%

3 or More Disabilities 3 298 2.5%

4 or More Disabilities 2 61 0.5%

PR-8A PERPETRATORS– BEHAVIORAL HEALTH CONDITIONS

NAMRS has eight distinct behavioral health screening or diagnosis data elements plus the Other 

category. Multiple behavioral health conditions can be submitted for the perpetrator. Four states 

reported on perpetrators’ behavioral health screenings or diagnoses (9,183 perpetrator records 

submitted). These data, for perpetrators with behavioral health conditions, do not include victims 

with a substantiation of Self-Neglect. “Exhibit PR-8a Perpetrators – Behavioral Health 

Conditions” displays the top two behavioral health conditions of perpetrators as Other and 

Substance Use Disorder. State examples of Other include specific behavioral health conditions not 

listed as a NAMRS data element value.

Exhibit PR-8a Perpetrators – Behavioral Health Conditions

Categories less than 0.5% and “None or Unknown” not shown above.

Behavioral Health Condition # of states 

submitting Count % of perpetrators (9,183)

Other Condition 2 1,348 14.7%

Substance Use Disorder 3 521 5.7%

Schizophrenia and Other Psychotic Disorders 2 73 0.8%

Dementia 1 54 0.6%

Alcohol Use Disorder 1 19 0.2%

Anxiety 1 1 0.0%

Bipolar Disorder 0 - -

Depression 0 - -

Traumatic Brain Injury 0 - -

“None or Unknown” 4 7,184 78.2%

14.7%

5.7%

0.8%

0.6%

0% 5% 10% 15% 20%

Other Condition

Substance Use Disorder

Schizophrenia and Other Psychotic...

Dementia
NAMRS FFY 2016 Report: Case Component 55

PR-8B PERPETRATORS– MULTIPLE BEHAVIORAL HEALTH CONDITIONS

“Exhibit PR-8b Perpetrators – Multiple Behavioral Health Conditions” indicates the number of 

perpetrators with multiple behavioral health conditions. These data, for perpetrators with multiple 

behavioral health conditions, do not include victims with a substantiation of Self-Neglect. No

condition was included for 78.2% of perpetrator records and 21.6% indicated only one condition.

Exhibit PR-8b Perpetrators – Multiple Behavioral Health Conditions

Perpetrators with Multiple 

Conditions # of states # of perpetrators

% of 

perpetrators 

(9,183)

No Condition 4 7,184 78.2%

Only 1 Condition 3 1,983 21.6%

2 or More Conditions 2 16 0.2%
NAMRS FFY 2016 Report: Case Component 56

CASE COMPONENT – CLIENT-PERPETRATOR RELATIONSHIPS

CPR-1 CLIENT-PERPETRATOR RELATIONSHIP RECORD SUBMISSION

“Exhibit CPR-1 Client-Perpetrator Relationship Record Submission” shows the client and 

perpetrator relationship data elements which include: Kinship Relationship, Cohabitation at Start 

and Close of Case; Perpetrator Association at Start and Close of Case; Perpetrator Substitute 

Decision Maker at Start and Close of Case; and Legal Remedies with Perpetrator. Nineteen of the 

24 states that submitted Case Component data reported on the kinship relationship between the 

client and perpetrator (25,954 relationship records submitted). These Client-Perpetrator 

Relationship data do not include victims with a substantiation of Self-Neglect.

Exhibit CPR-1 Client-Perpetrator Relationship Record Submission

Data Element

# of states 

that 

submitted

# of

records 

from 

states

# of 

records 

with data

% of 

records 

from states 

with data

% of 

total 

records 

(25,954)

Kinship Relationship 19 25,954 15,644 60.3% 60.3%

Cohabitation at Close 3 2,235 2,193 98.1% 8.4%

Perpetrator Association at 

Start 5 7,718 2,415 31.3% 9.3%

Cohabitation at Start 3 1,555 1,004 64.6% 3.9%

Perpetrator Association at 

Close 2 1,955 1,008 51.6% 3.9%

Perpetrator Legal Remedy 2 2,045 361 17.7% 1.4%

Perpetrator Substitute 

Decision Maker at Start 2 1,895 50 2.6% 0.2%

Perpetrator Substitute 

Decision Maker at Close 0 - - - -

CPR-2 CLIENT-PERPETRATOR RELATIONSHIPS – COHABITATION

NAMRS data reflect client and perpetrator cohabitation status at the start of the investigation and 

close of the investigation. “Exhibit CPR-2 Client-Perpetrator Relationships – Cohabitation”

displays the information provided by two states (1,189 relationship records submitted), which 

submitted the cohabitation both at the start and end of the investigation. It shows that close-ofinvestigation cohabitation was present in 71.4% of relationships. Of the 1,189 relationship records 

submitted, 638 records included cohabitation at the start of the investigation and 1,189 records

included cohabitation at the close of the investigation.
NAMRS FFY 2016 Report: Case Component 57

Exhibit CPR-2 Client-Perpetrator Relationships – Cohabitation

Unknown not shown above.

Client-Perpetrator 

Cohabitation

Start 

counts

% of relationships 

(1,189)

Close 

counts

% of relationships 

(1,189)

Yes 189 15.9% 340 28.6%

No 449 37.8% 849 71.4%

Unknown 551 46.3% - -

CPR-3 CLIENT-PERPETRATOR RELATIONSHIPS – KINSHIP RELATIONSHIP

The kinship relationship between the client and perpetrator was reported for less than 20% of 

relationships by 19 states (25,954 relationship records submitted). The top three kinship 

relationships displayed in “Exhibit CPR-3 Client-Perpetrator Relationships – Kinship 

Relationship” were Client’s Child at 25.6%, Other Relative at 11.5%, and Spouse at 9.1%. The 

client-perpetrator relationship was reported as “None or Unknown” for 39.7% of client records.

Reasons for Unknown values may include: recorded as Unknown in state reporting system or staff 

were not able to determine; and data records submitted to NAMRS did not contain the information, 

presumably because the information was not collected. The Kinship Relationship data do not 

include victims with a substantiation of Self-Neglect.

Exhibit CPR-3 Client-Perpetrator Relationships – Kinship Relationship

Categories less than one percent and “None or Unknown” not shown above.

0% 20% 40% 60% 80%

Yes

No

at Start at Close

25.6%

11.5%

9.1%

4.9%

3.4%

2.9%

2.2%

0% 5% 10% 15% 20% 25% 30%

 Child

 Other Relative

 Spouse

 Parent

 Grandchild

Kinship (Non-Specific)

 Sibling
NAMRS FFY 2016 Report: Case Component 58

Client-Perpetrator Kinship # of states that 

submitted Count

% of 

relationships 

(25,954)

Child 15 6,642 25.6%

Other Relative 16 2,977 11.5%

Spouse 19 2,355 9.1%

Parent 14 1,261 4.9%

Grandchild 11 878 3.4%

Kinship (Non-Specific) 5 752 2.9%

Sibling 13 560 2.2%

Domestic Partner/Civil Union 8 202 0.8%

Grandparent 6 17 0.1%

“None or Unknown” 16 10,310 39.7%

CPR-4 CLIENT-PERPETRATOR RELATIONSHIPS – PERPETRATOR ASSOCIATION AT START

NAMRS data provides information about the association between the client and perpetrator at the 

start of the investigation and close of the investigation. These data indicate if the perpetrator has a 

caregiving relationship to the client at the start of the investigation. Five states submitted this data 

element (7,718 relationship records submitted included at least one perpetrator association), for 

31.3% of the client-perpetrator relationships in those states. “Exhibit CPR-4 Client-Perpetrator

Relationships – Perpetrator Association at Start” shows that, of the known associations, 17.2% of 

client perpetrators were unpaid, nonrelative caregivers at the start of the investigation. These 

Client-Perpetrator Relationship Association at Start data do not include victims with a 

substantiation of Self-Neglect. 

Exhibit CPR-4 Client-Perpetrator Relationships – Perpetrator Association at Start

Categories less than one percent and “None or Unknown” not shown above.

17.2%

6.0%

3.2%

2.5%

1.2%

0% 5% 10% 15% 20%

 Unpaid Nonrelative Caregiver

Nursing Home Staff

Paid Relative Caregiver

Other Relationship

Nonrelative Caregiver (Non-Specific)
NAMRS FFY 2016 Report: Case Component 59

Perpetrator Associations at Start # of states 

submitting Count % of associations (7,718)

Unpaid Nonrelative Caregiver 1 1,331 17.2%

Nursing Home Staff 2 460 6.0%

Paid Relative Caregiver 1 245 3.2%

Other Relationship 1 196 2.5%

Nonrelative Caregiver (Non-Specific) 2 95 1.2%

Paid Nonrelative Caregiver 2 65 0.8%

Residential Care Community Staff 1 14 0.2%

Relative Caregiver (Non-Specific) 1 9 0.1%

Unpaid Relative Caregiver 0 - -

“None or Unknown” 5 5,303 68.7%

CPR-5 CLIENT-PERPETRATOR RELATIONSHIPS – PERPETRATOR ASSOCIATION AT CLOSE

“Exhibit CPR-5 Client-Perpetrator Relationships – Perpetrator Association at Close” specifies the 

association between the client and perpetrator at the close of the investigation. These data indicate

if the perpetrator has a caregiving relationship to the client at the close of the investigation. Two 

states provided this data element (1,955 relationship records submitted included at least one 

perpetrator association), for 51.6% of the client-perpetrator relationships in those states. These 

Client-Perpetrator Association at Close data do not include victims with a substantiation of SelfNeglect.

Exhibit CPR-5 Client-Perpetrator Relationships – Perpetrator Association at Close

Categories less than one percent and “None or Unknown” not shown above.

Perpetrator Associations at Close # of states 

submitting Count % of associations (1,955)

Other Relationship 1 773 39.5%

Nursing Home Staff 1 161 8.2%

Residential Care Community Staff 1 65 3.3%

Relative Caregiver (Non-Specific) 1 9 0.5%

Paid Relative Caregiver 0 - -

Unpaid Relative Caregiver 0 - -

Nonrelative Caregiver (Non-Specific) 0 - -

39.5%

8.2%

3.3%

0% 10% 20% 30% 40% 50%

Other Relationship

Nursing Home Staff

Residential Care Community Staff
NAMRS FFY 2016 Report: Case Component 60

Perpetrator Associations at Close # of states 

submitting Count % of associations (1,955)

Paid Nonrelative Caregiver 0 - -

Unpaid Nonrelative Caregiver 0 - -

“None or Unknown” 1 947 48.4%

CLIENT-PERPETRATOR RELATIONSHIPS – PERPETRATOR SUBSTITUTE DECISION MAKER

NAMRS requests information about perpetrators’ role as the clients’ substitute decision maker at 

the start and close of the investigation. This includes authorizations that are in effect related to 

health, personal, or financial decision making for the client. Two states submitted data for the start 

of the investigation for 55 of the 2,448 records the states submitted, or 2.2%. No state was able to 

submit the information at the close of the investigation. An exhibit was not produced due to lack 

of available data.

CPR-6A CLIENT-PERPETRATOR RELATIONSHIPS – PERPETRATOR LEGAL REMEDY 

RECOMMENDATIONS

“Exhibit CPR-6a Client-Perpetrator Relationships – Perpetrator Legal Remedy 

Recommendations” reveals the legal remedy recommendations among client and perpetrator 

relationships. Two states provided data on whether legal remedies were recommended or sought 

by the APS agency regarding the status of the perpetrator (2,045 relationship records submitted

included perpetrator legal remedy recommendations). Examples of other legal remedies include 

police/district attorney intervention, Ex Parte (temporary order), emergency guardianship, and 

guardianship. These Client-Perpetrator Legal Remedy Recommendations data do not include 

victims with a substantiation of Self-Neglect.

Exhibit CPR-6a Client-Perpetrator Relationships– Perpetrator Legal Remedy 

Recommendations

“None or Unknown” not shown above.

14.5%

4.1%

0.0%

0.0%

0.0%

0% 5% 10% 15% 20%

Other Legal Remedy

Restraining Order on Perpetrator

Removal of Guardianship Rights

Eviction of Perpetrator

Restitution by Perpetrator
NAMRS FFY 2016 Report: Case Component 61

Legal Remedy Recommendations # of states 

submitting Count % of relationships (2,045)

Other Legal Remedy 2 296 14.5%

Restraining Order on Perpetrator 2 83 4.1%

Removal of Guardianship Rights 0 - -

Eviction of Perpetrator 0 - -

Restitution by Perpetrator 0 - -

“None or Unknown” 2 1,684 82.3%

CPR-6B CLIENT-PERPETRATOR RELATIONSHIPS – MULTIPLE PERPETRATOR LEGAL REMEDY

Multiple code values can be submitted for the client-perpetrator relationship’s legal remedy 

recommendation. “Exhibit CPR-6b Client-Perpetrator Relationships – Multiple Perpetrator Legal 

Remedy Recommendations” indicates that legal remedy recommendations were either not known 

or were not sought in 82.3% of records submitted. These Client-Perpetrator Multiple Perpetrator 

Legal Remedy Recommendations data do not include victims with a substantiation of SelfNeglect.

Exhibit CPR-6b Client-Perpetrator Relationships – Multiple Perpetrator Legal Remedy 

Recommendations

Relationships with Multiple Remedies # of states # of 

relationships

% of relationships 

(2,045)

No Remedy 2 1,684 82.3%

Only 1 Remedy 2 343 16.8%

2 or More Remedies 2 18 0.9%

End of NAMRS FFY 2016 Report 3: Case Component

For more information about NAMRS please direct inquiries to 

ACL Program Officer Stephanie Whittier Eliason