WASHINGTON — The Department of Veterans Affairs released the newest performance ratings Wednesday for each of its 146 hospitals, citing improvements in the past year at some of its lowest-performing facilities.

The fiscal 2018 ratings include nine one-star hospitals, the lowest possible, down from 14 hospitals that received one-star ratings in 2017.

The ratings indicate each hospital’s quality of care and are based on data such as death rates, patient satisfaction and efficiency. In years past, the VA had withheld the data from the public. In 2016, the performance ratings were released under pressure that followed a USA Today investigation.

Overall, 38 hospitals improved their star ratings in 2018, 40 dropped in the ratings and 68 stayed the same as last year.

Five VA hospitals received one-star ratings in 2017 and 2018: Big Springs and El Paso, Texas; Loma Linda, Calif; Memphis, and Phoenix. Four other hospitals were added to the worst-rated this year: Montgomery, Ala.; Tucson, Ariz.; Washington, D.C., and Atlanta.

VA hospitals in Dublin, Ga.; Fresno, Calif.; Roseburg and White City, Ore.; Walla Walla, Wash.; Harlingen, Texas; Nashville and Murfreesboro, Tenn., and Biloxi, Miss., improved enough from 2017 to get off the list of lowest-rated hospitals.

Eighteen hospitals received 5 stars in 2018, the best possible. Four of them are located in Pennsylvania.

“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. ““There’s no doubt that there’s still plenty of work to do, but I’m proud of our employees, who work tirelessly to move VA in the right direction for veterans and taxpayers.”

wentling.nikki@stripes.com Twitter: @nikkiwentling

Migrated