More than 97 percent of the state's nursing homes were cited for deficiencies in 2007, a slight decrease from the year before, but still among the top 12 in the country in terms of percentage of violations, according to a federal report.

The Office of Inspector General report showed that 97.4 percent of Hawai'i's nursing facilities were cited for violations and deficiencies last year, compared with 97.9 percent in 2006 and 100 percent in 2005. The survey, released Monday, looked at 190 possible deficiencies that fell in 16 categories, including resident rights, nursing and physician services, infection control and quality of life.

Hawai'i and Arizona were tied for 12th in the nation at 97.4 percent, with Alaska, Idaho, Wyoming and the District of Columbia topping the list with 100 percent of their facilities being cited, according to the report.

The average number of deficiencies per Hawai'i nursing facility was seven in 2007, unchanged from 2006 and down from the 8.5 reported in 2005. Nursing homes in the District of Columbia received an average of 14.4 violations, the highest anywhere in the country.

There are 50 nursing home facilities in Hawai'i that receive Medicare or Medicaid reimbursements, according to the state Department of Health's Web site.

Nationally, 91 percent of the nursing homes surveyed received deficiency violations in each of the past three years. Of these, 17 percent of the homes were cited for actual harm or immediate jeopardy deficiencies, and 3.6 percent were cited for substandard quality of care.

The report did not specify the types or severity of the violations for each state. The OIG also did not make any recommendations for improvements.

The Centers for Medicare and Medicaid Services contracts the states to perform the nursing home surveys before the facilities can be certified. All nursing homes that participate in Medicare or Medicaid must be certified as meeting certain federal requirements.

A spokesman for Medicare said the number of violations may be up because the agency is strengthening safety requirements and inspecting facilities more frequently.

"The addition of stronger inspections and enforcement of quality of care requirements means that more of the serious deficiencies are being identified, even though many nursing homes also made improvements in their care," Jeff Nelligan said.

In a separate report, a survey by the MetLife Mature Market Institute revealed that the cost for adult daycare services in Hawai'i this year has averaged $59 daily, compared with the national average of $64 a day. The report showed that the hourly average wage for a home health aide here was $23, compared with $20 nationally, while a homemaker/companion cost about $21, compared with $18 nationwide.

Bloomberg News Service contributed to this report.