WASHINGTON – The number of one-star Veterans Affairs hospitals has dropped from 14 to nine since last year, according to star rankings the VA released Wednesday.

Five VA hospitals remain at the bottom of the rankings for the third straight year, including in Big Spring and El Paso, Texas; Loma Linda, California; and Phoenix, where a wait-time crisis in 2014 triggered a national scandal.

Also among the one-star hospitals for the third year in a row is the VA medical center in Memphis, Tennessee, where USA TODAY reported patient safety problems have soared in recent years.

Overall, 40 VA hospitals dropped one star or more, 68 stayed the same and 38 improved in the rankings. The largest improvement was in Hot Springs, South Dakota, which went from two stars to five.

“With closer monitoring and increased medical center leadership and support, we have seen solid improvements at most of our facilities,” VA Secretary Robert Wilkie said in a statement. “Even our highest performing facilities are getting better, and that is driving up our quality standards across the country.”

The VA regularly scores 146 of its medical centers based on dozens of quality factors, including death and infection rates, instances of avoidable complications and wait times. The agency uses a five-star scale on which one is the worst and five the best.

The rankings compare VA hospitals against each other, but the number of one-star hospitals is not constant. Medical centers in that bracket can be elevated to two stars based on quality-of-care factors.

The agency did not start releasing the ratings until USA TODAY obtained and published them for the first time in 2016. The VA then committed to posting them annually.

More:New VA hospital rankings: The worst still the worst

The VA also rates 133 agency nursing homes on a one-to-five star scale and kept those ratings from the public until learning this year that USA TODAY and The Boston Globe planned to publish them.

Those ratings, unlike the hospital rankings, take private-sector nursing home averages into account. As of March 31, nearly half of VA nursing homes – 58 – received the lowest one-star rating.

Use the column heads below to sort by city, state or star rating or to see how this year’s hospital ratings compare with last year.