The Atlanta VA Medical Center received low marks from the federal government for its performance, according to newly released ratings.

The Department of Veterans Affairs on Wednesday announced that two-thirds of VA hospitals included in a survey of hospital quality ratings received four or five stars out of five. The Atlanta VA Medical Center, by comparison, received two stars out of five.

These ratings were produced by the Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services. This is the first time VA hospitals were included in the CMS hospital ratings.

The quality ratings for each hospital are based on performance in five categories: mortality, safety of care, readmission, patient experience, and timely and effective care.

A spokesperson for the VA said that it is focused on improving care, and that while the recent hospital rates for the Atlanta VA were “not up to our standards” it doesn’t reflect recent improvements since it relied on data from 2018 to 2021. They cited several examples, including a decreased mortality rate for heart failure and chronic obstructive pulmonary disease as well as increasing patient access to the emergency department.

“We are encouraged by positive data trends from the past year, which demonstrate the commitment of the leadership and staff of the Atlanta VA [Health Care System] to delivering care that is safe, efficient, effective, timely, and Veteran focused,” a VA spokesperson said in a statement. “We recognize there is still work to do, and as a learning organization, we are committed to continuous improvement. We will not rest until we meet our goal of providing the best possible care to every Veteran, every time.”

Nationally, the Department of Veterans Affairs heralded the survey results which showed that VA hospitals are outperforming non-VA hospitals. In total, 67% of the VA hospitals included in the survey received 4 or 5 stars, compared to only 41% of non-VA hospitals.

“Whenever a Veteran entrusts us with their care, they deserve to know that they’re getting the very best,” VA Secretary Denis McDonough said in a statement. “That’s what we strive for in every hospital across the nation, and we will never settle for anything less.”