The Atlanta VA Medical Center shuffled some of its top leaders Thursday after it was designated one of the worst in the nation.

The changes, which are mostly temporary, took place as internal watchdogs with the U.S. Department of Veterans Affairs look into why the hospital's quality rating dropped to one star out of a possible five. This decline placed the Atlanta VA among the lowest-scoring 10 percent of the department's 100-plus medical centers nationwide.

“To be clear, this is not an indication of misconduct on the part of any Atlanta VAMC employee,” said Director Leslie Wiggins, director of Veterans Integrated Service Network 7, which oversees the Atlanta VA, in a written statement. “Rather, we are making these changes out of an abundance of caution so that veterans can have the utmost confidence in the facility’s commitment to quality of care.”

Among those leaving their posts is hospital Chief of Staff David Bower, who opted to retire, according to a news release. The hospital’s deputy chief of staff and chiefs of the emergency, primary care and clinical access services departments have all moved to other positions.

The star ranking evaluates factors such as access to care, customer service, deaths from urgent health conditions and avoidable infections. The federal agency assigns stars based on where the hospital’s scores fall compared to other VA medical centers.

Atlanta VA director Annette P. Walker remains in her post.

Temporary staff changes are typical during an investigation, said Division 7 spokeswoman Paige Fluker.

“We want to find out what’s going on so we can begin rectifying any challenges we’re having,” Fluker said. Many of these staffers may return to their former positions once the investigation is completed.

The Atlanta VA has experienced a series of troubles this year. Inspectors discovered more than one ton of hazardous waste packed floor to ceiling in unsafe conditions, according to a state Environmental Protection Division enforcement order signed Sept. 25. The medical center agreed to pay the state agency $13,600.

A Sept. 13 report by the VA's Office of Inspector General found that the Women Veterans Health Program failed to complete mammograms for 42 patients over nearly three years. Another found that the Atlanta VA had the worst staffing shortages in the country.