HARLINGEN – Administrators at the Harlingen Veterans Administration facility said they're working hard to make things better.

It was one of three Texas facilities ranked among the lowest performing in the country in a recent Veterans Affairs review.

Those three facilities earned a one out of a five star ranking.

The ranking is a bit misleading because the study also showed Harlingen's facility made significant improvements.

Over the course of the year, the Harlingen clinic earned one star. They know they can do better.

Dr. Kathleen Kendle, Harlingen's acting associate chief of staff for Primary Care, said, "One star is not exactly what we would have wanted."

The Department of Veterans Affairs looks at 25 different factors when it compiles its rankings.

It compares each hospital against each other and grades on a curve.

Dr. Kendle said, "It does make it statistically possible for us to improve in a variety of measures, but yet go down in the star rating because other facilities have improved at a faster rate."

The report reveals Harlingen improved on things like mental health care; their work environment and RN turn over. They cut down on turnover of nurses by about 40 percent.

Those who work closely with veterans know what shortcomings to expect.

Felix Rodriguez, Hidalgo County Veterans Service Officer, said, "Timeliness of appointments. Appointments being scheduled. The Choice Card program."

Russ Duerstine, Senior Field Director for Concerned Veterans for America, said, "Many times it's not an issue of the quality of the care but how long it takes to get it."

Responsiveness to veterans is an area Harlingen is aware needs to get better.

Preventative measures like health screenings and primary care wait times for new patients are also on that list of things to improve.

Ambulatory care for sensitive conditions needs a closer look, too agrees Dr. Kendle.

"This looks at those patients that are hospitalized with a condition that could be seen and evaluated in primary care,” said Dr. Kendle. “So, patients who are admitted for heart failure, diabetes, hypertension, dehydration, ruptured appendix, urinary tract infection, those things that could be taken care of primary care."

Veterans' Choice, the program that allows veterans to get outside care, is not on this list. The things that contribute to making it work are.

Concerned Veterans for America is supporting legislation to change that measure.

Until then, these ratings will be used to better inform hospitals like Harlingen what needs to change.

Both veteran representatives CHANNEL 5 NEWS spoke with and the veteran’s administration agree veterans' voices are important.

Organizations like the Concerned Veterans for America advocate on behalf of veterans and their families.

Hospitals also send out surveys every month. It's called Survey Healthcare Experience of Patience, SHEP. These surveys are important to making improvements.

That feedback from veterans account for a third of what the VA considers in the star ratings.

The Harlingen hospital said only about a third of veterans who use their facility fill out those surveys.

If anyone would like to view the star ratings across the nation, they can click here. Anyone can view the SAIL report for the Harlingen hospital here.