The Department of Veterans Affairs has released its latest hospital ratings, and the numbers aren’t good for Texas. The Lone Star State has three hospitals that received a one-star rating, the lowest possible score on the VA’s one through five scale. That’s tied with Tennessee as the state with most poor performing VA hospitals.

The VA medical centers in Big Spring and El Paso scored a one for the second year in a row. The VA medical center in Harlingen joined the two hospitals in 2017 with one-star rating. In all, three of the nation’s 14 VA medical centers with the worst scores are located in Texas.

The VA scores its hospitals based on several factors, including death and complication rates, patient satisfaction and scheduling delays, a thorny issue at local VA hospitals and clinics, where scheduling clerks have told investigators they have been ordered to falsify wait times by supervisors.

The rankings were first obtained by USA Today, whose release of the numbers last year spurred the VA to make the releases public.

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Closer to home, VA hospitals performed better.

The Central Texas Veterans Health Care System, headquartered in Temple and which encompasses the Austin Outpatient Clinic, scored a three for the second year in a row.

Both the San Antonio and Dallas VA medical centers improved from a two to a three and the Michael E. DeBakey VA Medical Center in Houston scored a four.

VA spokesman Curt Cashour noted that 64 percent of medical centers saw their rankings improve between 2016 and 2017 and said transparency is a "crucial component" of the department’s reform efforts.