New York’s hospitals remained near the bottom of two quality report cards issued last week.

In an update to Hospital Compare, a consumer guide from the U.S. Centers for Medicare & Medicaid Services, the state’s hospitals received an average of 2.46 out of 5 stars—the lowest of any state except Nevada and the District of Columbia.

That’s still an improvement compared to 2019, when New York was 50th out of 50 states with an average rating of 2.18 stars.

The nationwide Hospital Compare average also improved, from 3.08 to 3.24—in part reflecting a change in how CMS synthesizes data on dozens of quality measures into a single rating.

New York’s roster of five-star institutions went from just one in 2019 to seven this year: Guthrie Cortland Regional Medical Center, the Hospital for Special Surgery, Northern Dutchess Hospital, Northwell Health’s Huntington Hospital, NYU Langone Medical Center, Oneida Healthcare Center and the St. Francis Hospital & Heart Center.

Five-star ratings accounted for 5 percent of all grades given in New York, compared to 14 percent nationwide.

New York also fared poorly in the quarterly “Hospital Safety Grade” report from the Leapfrog Group, a private watchdog. Just 10.7 percent of the state’s hospitals received an “A” for avoiding medical errors and other measures of preventable harm, a slight improvement from 9.8 percent last fall. However, its ranking among the 50 states dropped from 45th to 46th.