The federal government released its first overall quality ratings for 3,617 hospitals last week. Just 102 hospitals graded by the Centers for Medicare & Medicaid received the top score of five stars. Nine are located in California. The agency awarded the lowest rating of one star to 129 hospitals, including 11 in California.

The ratings have been criticized by the American Hospital Association as confusing for patients and families. But CMS said in a statement that “publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries.”

Read more about how California hospitals compare here, and see all of the rankings here.