Quality reviews for the VA Puget Sound Health Care System lagged far behind the top performers in the Department of Veterans Affairs health care network in evaluations over the past year-and-a-half.

The Seattle Times obtained six reviews in an 18-month period that ended in June. The newspaper reports the Puget Sound VA never received more than two out of five stars for overall quality.

The Puget Sound VA has hospitals at Seattle and American Lake and seven outpatient clinics. They served nearly 89,000 patients in the past fiscal year.

VA officials say the evaluations are a learning tool not intended to rank performances for the public. Chief of Staff William Campbell says Puget Sound VA compares "very favorably" with Seattle area hospitals.