What is NCI-AD?

Establish in 2015, National Core Indicators—Aging and Disabilities™ (NCI-AD™) is a voluntary effort by state aging and physical disability agencies to measure and track their performance using a standardized set of nationally validated measures. The effort is coordinated by Advancing States and Human Services Research Institute (HSRI). Learn more about our history here.

In 2021-22 a total of 19 states participated in NCI-AD. Not all participating states do all surveys every year.

What is the NCI-AD
Adult Consumer Survey?

The NCI-AD Adult Consumer Survey (ACS), is standardized survey conducted with a person receiving long term services and supports (LTSS) through state aging and physical disability systems. Surveys are conducted by trained surveyors through in-person, secure video meeting, or over-the-phone conversations with service participants. The main part of the survey contains subjective questions about how well services are supporting the person; these can only be answered by the person themselves. A subset of more objective questions may be answered by a proxy respondent if needed. In addition to the questions for service participants, the survey also collects background information on the person –demographic and service-related data – mainly from service agency records. In 2021-22, the survey included two state-optional modules:

Person-Centered Planning Module. This is a series of questions that ask about the person-centered planning process, including the person’s experience developing the service plan and the service planning meeting. The following states conducted the Person-Centered Planning Module: CO, DE, GA, IN, KS, MI, MN, MO, NJ, OK, TX, WA, WI.

COVID-19 Supplement. This included a series of questions of the person’s experience with services during COVID-19 and the overall impact of the pandemic on the person’s life. The following states conducted the COVID-19 Supplement: CO, DE, GA, IN, KS, MI, MN, MO, NJ, OK, TX, WA, WI.

Sampling

There is considerable variation in how states’ long-term services and supports (LTSS) programs serving older adults and adults with physical disabilities are organized, funded, and administered. The NCI-AD program allows states to include programs funded through Medicaid, the Older Americans Act, Program of All-Inclusive Care for the Elderly (PACE), state-only funds, and/or other state- and federal-blended funds. The NCI-AD project team works closely with each participating NCI-AD state to advise and track which LTSS program populations and sub-populations are included in the state’s sampling strategy, how that sample is designed and how many surveys are targeted for completion. See detailed information on state sample frames here.

Washington Specific Sample

Total Sample Frame: 60100

Total surveys completed: 1263

Overall Margin of Error 2.73%

Program Category

Table 1. Classification of 2021-22 State programs

STATE Program Funding Source Description of Program Total Population Eligible for NCI-AD Total Usable Surveys Collected MoE (95%Confidence, 0.5 Distribution) MoE (95%Confidence, 0.7 Distribution)
WA In-home N/A N/A 47801 832 3.40% 3.11%
WA Adult Family Home N/A N/A 8202 152 7.95% 7.29%
WA Assisted Living N/A N/A 3770 37 16.11% 14.77%
WA Residential Care N/A N/A 2101 67 11.97% 10.97%
WA Nursing Home N/A N/A 10063 175 7.41% 6.79%

What is included in this report?

This report presents Washington 2021-22 ACS demographics and outcomes results. Data are shown for the overall statewide average, broken out by program sampled, and include the weighted NCI-AD Average.

Please note: Extreme caution should be used when interpreting results where the number of valid responses is small. Each program’s valid number of responses (valid Ns) is shown in every chart and table in this report.

To protect people’s privacy we do not show the data when 20 or fewer people from a state or within a program responded to a question, however their data are included in the overall state average.

Presentation of Data

Data may be viewed as bar charts or in tables by clicking the appropriate tab for each outcome. Data presented in charts are “collapsed” meaning that data grouped by response options to what is considered to reflect a positive outcome and all other responses. Tables represent the un-collapsed data outcomes.

All NCI-AD data are collapsed “yes” responses only, unless otherwise noted.

All state and NCI-AD averages throughout this report are “weighted” to account for any non-proportional sampling of programs and to “rebalance” the states’ sample sizes according to their populations of survey-eligible service recipients. See more details on weighting in Part II of this report.

Results

Demographics

Table 2. Average age (reported for those under 90 years old)

Program Age N
In-home 64.6 780
Adult Family Home 67.8 138
Assisted Living 61.7 35
Residential Care 72.6 48
Nursing Home 69.1 160
Overall State Average 66.0 1161
NCI-AD Weighted Average 66.8 12847

Table 3. Age Category (including those 90 and older)

Program 18-44 45-64 65-89 90+ N
In-home 9% 34% 52% 5% 819
Adult Family Home 7% 28% 57% 9% 152
Assisted Living 12% 37% 45% 6% 37
Residential Care 1% 16% 55% 28% 67
Nursing Home 3% 24% 65% 7% 172
Overall State Average 8% 31% 55% 7% 1247
NCI-AD Weighted Average 8% 27% 58% 6% 13593

Table 4. Gender

Program Male Female Other Don’t know or unclear N
In-home 28% 72% 0% 0% 811
Adult Family Home 41% 59% 0% 0% 150
Assisted Living 47% 53% 0% 0% 36
Residential Care 24% 76% 0% 0% 67
Nursing Home 35% 65% 0% 0% 174
Overall State Average 31% 69% 0% 0% 1238
NCI-AD Weighted Average 32% 68% 0% 0% 13595

Table 5. Race and ethnicity

Program American Indian or Alaska Native Asian Black or African American Pacific Islander White Hispanic or Latino Other Don’t know Unclear/Refused/No Response N
In-home 2% 11% 8% 2% 71% 0% 1% 1% 5% 817
Adult Family Home 1% 6% 5% 1% 83% 0% 1% 1% 2% 152
Assisted Living 6% 0% 0% 0% 87% 0% 0% 3% 5% 37
Residential Care 0% 0% 0% 0% 97% 0% 0% 1% 1% 67
Nursing Home 3% 4% 9% 0% 75% 0% 1% 2% 8% 175
Overall State Average 2% 8% 7% 1% 75% 0% 1% 1% 5% 1248
NCI-AD Weighted Average 2% 5% 23% 0% 60% 9% 2% 3% 2% 13134

Table 6. Marital Status

Program Single, never married Married or in domestic partnership Separated or divorced Widowed Don’t know or unclear N
In-home 24% 20% 38% 18% 0% 809
Adult Family Home 34% 11% 28% 25% 2% 151
Assisted Living 41% 9% 38% 12% 0% 37
Residential Care 23% 11% 23% 38% 6% 66
Nursing Home 26% 12% 38% 19% 4% 167
Overall State Average 26% 17% 36% 20% 1% 1230
NCI-AD Weighted Average 28% 15% 27% 25% 4% 13114

Table 7. Preferred Language

Program English Spanish Other Don’t know or unclear N
In-home 71% 6% 23% 0% 817
Adult Family Home 90% 0% 9% 1% 152
Assisted Living 97% 0% 3% 0% 37
Residential Care 100% 0% 0% 0% 67
Nursing Home 92% 4% 4% 0% 175
Overall State Average 79% 4% 16% 0% 1248
NCI-AD Weighted Average 89% 4% 7% 0% 13409

Table 8. Residential Designation

Categories created using zip codes and corresponding RUCA codes

Program Metropolitan Micropolitan Rural Small Town N
In-home 85% 11% 2% 2% 823
Adult Family Home 96% 1% 1% 2% 152
Assisted Living 74% 18% 5% 3% 37
Residential Care 82% 9% 4% 4% 67
Nursing Home 90% 8% 1% 2% 173
Overall State Average 86% 9% 2% 2% 1252
NCI-AD Weighted Average 72% 14% 6% 9% 13085

Table 9. Median Income (based on zip code)

Newly reported in 2021-2022

Program $0- $9,999 $10,000- $19,999 $20,000- $29,999 $30,000- $39,999 $40,000- $49,999 $50,000- $59,999 $60,000- $69,999 $70,000- $79,999 $80,000- $89,999 $90,000- $99,999 $100,000 and over N
In-home 0% 0% 1% 12% 28% 24% 20% 8% 6% 1% 0% 821
Adult Family Home 0% 0% 0% 3% 18% 21% 36% 13% 7% 0% 1% 151
Assisted Living 0% 0% 2% 18% 28% 36% 13% 3% 0% 0% 0% 37
Residential Care 0% 0% 0% 20% 25% 38% 9% 1% 6% 0% 0% 67
Nursing Home 0% 0% 1% 18% 28% 20% 19% 10% 1% 3% 0% 171
Overall State Average 0% 0% 1% 13% 27% 24% 21% 9% 5% 1% 0% 1247
NCI-AD Weighted Average 0% 1% 9% 27% 27% 16% 9% 5% 3% 1% 1% 12977

Table 10. Type of Residence

Program Own or family house or apartment Senior living apartment or complex Group home, adult family home, foster home, host home Assisted living facility, residential care facility Nursing facility, nursing home Homeless or temporary shelter Other Don’t know or unclear N
In-home 95% 4% 1% 0% 0% 0% 1% 0% 821
Adult Family Home 3% 0% 95% 1% 1% 0% 0% 0% 152
Assisted Living 0% 0% 9% 81% 10% 0% 0% 0% 37
Residential Care 1% 0% 0% 96% 2% 0% 0% 0% 67
Nursing Home 2% 0% 0% 1% 98% 0% 0% 0% 175
Overall State Average 60% 2% 12% 7% 18% 0% 0% 0% 1252
NCI-AD Weighted Average 76% 7% 2% 7% 6% 0% 2% 1% 13448

Table 11. Who the person lives with

Program No One – Lives Alone Spouse or Partner Other Family Friend(s) Live-in PCA Others Don’t know or unclear N
In-home 44% 19% 39% 1% 6% 3% 0% 813
Adult Family Home 37% 2% 1% 1% 30% 56% 1% 152
Assisted Living 49% 3% 2% 0% 0% 46% 0% 37
Residential Care 70% 3% 1% 0% 1% 21% 3% 67
Nursing Home 29% 2% 2% 0% 4% 66% 1% 173
Overall State Average 42% 13% 25% 1% 8% 23% 0% 1242
NCI-AD Weighted Average 47% 13% 28% 2% 2% 9% 1% 13355

Table 12. Address Change

Program Yes No Don’t know or unclear N
In-home 3% 96% 0% 813
Adult Family Home 6% 94% 0% 151
Assisted Living 5% 88% 7% 37
Residential Care 1% 97% 2% 67
Nursing Home 23% 74% 3% 172
Overall State Average 7% 92% 1% 1240
NCI-AD Weighted Average 6% 92% 2% 12980
Program No Yes N
In-home 97% 3% 812
Adult Family Home 94% 6% 151
Assisted Living 95% 5% 35
Residential Care 98% 2% 66
Nursing Home 77% 23% 167
Overall State Average 93% 7% 1231
NCI-AD Weighted Average 94% 6% 12752

Table 13. Where people moved from (if moved in the last 6 months)

Program Own or family house or apartment Senior living apartment or complex Group home, adult family home, foster home, host home Assisted living facility, residential care facility Nursing facility, nursing home Homeless or temporary shelter Other Don’t know or unclear N
In-home 82% 4% 0% 0% 0% 7% 7% 0% 28
Nursing Home 50% 3% 8% 11% 11% 3% 13% 1% 39
Overall State Average 59% 3% 7% 7% 8% 4% 13% 1% 77
NCI-AD Weighted Average 63% 5% 4% 5% 5% 3% 14% 1% 689
* The following programs had an N of less than 20 and were not shown: Adult Family Home, Assisted Living, Residential Care

Table 14. Diagnoses

All categories except ‘physical disability’, ‘intellectual or other developmental disability’, and ’Alzheimer’s disease or other dementia are new in 2021-22. Categories are not mutually exclusive; therefore, N is not shown.

Program Physical Disability Traumatic brain injury or other acquired brain injury Intellectual or other developmental disability Alzheimer’s disease or dementia Heart Disease Cancer Chronic Obstructive pulmonary disease (COPD) Stroke Diabetes Hypertension (or high blood pressure
In-home 69% 12% 10% 11% 29% 14% 22% 20% 39% 61%
Adult Family Home 57% 19% 13% 41% 19% 7% 13% 22% 21% 44%
Assisted Living 52% 26% 16% 21% 16% 16% 8% 25% 16% 44%
Residential Care 43% 5% 7% 22% 29% 13% 15% 17% 29% 46%
Nursing Home 67% 17% 14% 18% 30% 15% 18% 34% 32% 52%
Overall State Average 65% 14% 11% 16% 27% 13% 19% 23% 35% 56%
NCI-AD Weighted Average 70% 11% 8% 11% 33% 12% 23% 20% 37% 60%

Table 15. Person has chronic psychiatric or mental health diagnosis

Program Yes No Don’t know or unclear N
In-home 32% 66% 2% 799
Adult Family Home 35% 58% 6% 145
Assisted Living 57% 39% 3% 35
Residential Care 30% 62% 8% 62
Nursing Home 28% 64% 8% 169
Overall State Average 32% 64% 4% 1210
NCI-AD Weighted Average 35% 61% 3% 12828

Table 16. Level of Mobility

Categories are not mutually exclusive (except ‘Don’t know or unclear or unclear’).

Program Non-Ambulatory Moves self with wheelchair Moves self with other aids Moves self without aids Don’t know or unclear N
In-home 5% 24% 62% 34% 0% 812
Adult Family Home 21% 35% 39% 31% 1% 150
Assisted Living 3% 29% 35% 50% 0% 36
Residential Care 7% 31% 47% 24% 1% 67
Nursing Home 17% 52% 39% 12% 1% 173
Overall State Average 9% 31% 54% 29% 0% 1238
NCI-AD Weighted Average 8% 21% 53% 27% 8% 13086

Table 17. Has history of frequent falls (more than two falls in a six-month period)

Program Yes No Don’t know or unclear N
In-home 32% 67% 1% 810
Adult Family Home 23% 76% 1% 149
Assisted Living 27% 69% 3% 34
Residential Care 20% 77% 3% 65
Nursing Home 30% 67% 3% 166
Overall State Average 30% 69% 1% 1224
NCI-AD Weighted Average 28% 70% 1% 12866

Table 18. Receives Medicare

Program Yes No Don’t know or unclear N
In-home 86% 11% 3% 787
Adult Family Home 80% 12% 8% 143
Assisted Living 78% 10% 11% 34
Residential Care 72% 16% 13% 63
Nursing Home 83% 12% 6% 167
Overall State Average 84% 11% 5% 1194
NCI-AD Weighted Average 79% 18% 3% 12473

Table 19. Length of time receiving LTSS services in current program

Program 0 - 5 months 6 months – less than 1 year 1 year – less than 3 years 3 or more years Don’t know or unclear N
In-home 1% 8% 24% 68% 0% 818
Adult Family Home 1% 10% 33% 54% 2% 150
Assisted Living 3% 10% 23% 60% 5% 36
Residential Care 1% 6% 25% 65% 2% 67
Nursing Home * 0% 3% 4% 0% 93% 152
Overall State Average 1% 7% 22% 55% 15% 1223
NCI-AD Weighted Average 7% 6% 28% 54% 5% 11942

Outcome Tables and
Comparisons across Programs

Community Participation

Table 21. Gets to do things outside of their home as much as they want to

Bar chart

Table

Program Yes No N
In-home 62% 38% 659
Adult Family Home 62% 38% 60
Assisted Living 65% 35% 21
Residential Care 70% 30% 40
Nursing Home 35% 65% 110
Overall State Average 58% 42% 890
NCI-AD Weighted Average 62% 38% 9950

Table 22. Takes part in activities with others as much as they want to (in-person or virtually)

Question changed in 2021-22

Bar chart

Table

Program Yes Sometimes No N
In-home 61% 12% 27% 651
Adult Family Home 69% 10% 21% 61
Assisted Living 77% 0% 23% 23
Residential Care 78% 12% 10% 40
Nursing Home 46% 12% 41% 111
Overall State Average 60% 12% 28% 886
NCI-AD Weighted Average 58% 11% 31% 9904

Table 23. Reasons cannot always take part in activities with others as much as they want to (in-person or virtually)

Bar chart