The federal government’s Nursing Home Compare website has released new ratings, and they have docked nearly a third of the nursing homes in America due to tougher standards.

The government rankings the facilities on a five-star quality scale, which is used by 1.5 million consumers to judge the quality of care at 15,000 different nursing homes, according to a USA Today report.

The ratings include sweeping changes in how they are evaluated, including measuring the use of anti-psychotic drugs which can be extremely bad for older adults if prescribed incorrectly. The rankings also include more refined metrics to ensure that a facility has enough staff to provide good care.

Although 61 percent of nursing homes received a lower score under the new system, they didn’t drop enough to affect the overall rating of the facility, but 28 percent lost a full star, including 1,200 that originally were labeled five-star facilities. Three percent of facilities declined by two stars.

Nursing homes use these scores to gauge how well they’re doing, and those that get top marks often advertise that fact in their marketing, showing just how important the rankings are to these facilities.

A new, tougher ranking system is essential to drive “continuous improvements” in the care of the elderly, and since the standards hadn’t been updated since 2008, it was time to revisit it and raise the bar, said Patrick Conway, deputy administrator and chief medical officer at the federal Centers for Medicare and Medicaid Services, as quoted in the USA Today report.

The average overall rating among nursing homes declined from 3.46 stars to 3.14 stars, and only 341 facilities – 2.3 percent of the total — actually had rating increase.

Scores for quality of care was where the biggest drops were, as it fell from an average of 4.18 stars to 3.3 stars. This category was affected by new data on anti-psychotic drugs.