Frequently Asked Questions About The Leapfrog Hospital Safety Grade
What is the Leapfrog Hospital Safety Grade?
The Leapfrog Hospital Safety Grade is an “A,” “B,” “C,” “D,” or “F” assigned to general hospitals in the U.S., the only ratings program focused exclusively on how safe hospitals are for patients. The Safety Grade uses evidence-based patient safety measures including rates of preventable errors, injuries and infections, and whether hospitals have systems in place to prevent them. Safety Grades are updated twice annually, in the fall and spring, and are freely available to the public at hospitalsafetygrade.org. The Hospital Safety Grade uses a public, peer-reviewed methodology, calculated by top patient safety experts under the guidance of a National Expert Panel, and is 100% transparent and free to the public.
Why should people worry about a hospital's safety? Aren't all hospitals the same?
It is critical to monitor safety before choosing a hospital. Preventable medical errors, accidents, injuries and infections in hospitals kill upwards of 200,000 people every year, the third leading cause of death in the United States. One in four people admitted to a hospital suffers some form of avoidable harm. And all hospitals are not the same; some hospitals are much safer than others.
What is the difference between the Leapfrog Hospital Survey and the Leapfrog Hospital Safety Grade?
The Leapfrog Hospital Survey is an annual voluntary survey in which Leapfrog asks hospitals to report quality and safety data and then publicly reports that information by hospital. The Leapfrog Hospital Safety Grade is a letter grade Leapfrog bi-annually assigns to general hospitals in the United States, whether they voluntarily report data to Leapfrog or not. Most of the data used to calculate the Grade comes from the Centers for Medicare and Medicaid Services (CMS), the federal agency that runs Medicare. If a hospital voluntarily reports to the Leapfrog Hospital Survey, some of that data is used to calculate a Safety Grade.
Does a hospital get a better Safety Grade if it reports to the Leapfrog Hospital Survey?
Reporting to the Leapfrog Hospital Survey doesn’t automatically improve a hospital’s Safety Grade. If a hospital does well on the Leapfrog Hospital Survey that can improve their Grade, but if they do poorly it can hurt their Grade.
See fall 2025 Hospital Safety Grade methodology here.
Why don't I see my hospital?
Unfortunately, not all hospitals have enough data publicly available to be eligible for a Grade. As per the National Expert Panel guidance, The Leapfrog Group has requirements for the minimum amount of data we need to issue an accurate Grade. Most of the data Leapfrog uses comes from CMS, and in some cases, CMS does not publish adequate safety data on an individual hospital. Sometimes the hospital is too small to issue reliable numbers, or the hospital does not offer services relevant to the safety data. For instance, a hospital without an Intensive Care Unit (ICU) cannot report ICU safety measures. The absence of a Grade does not mean a hospital is unsafe; it means Leapfrog does not have enough data to assign a Grade.
How does Leapfrog determine the Grades?
Leapfrog experts and advisors at the Johns Hopkins Armstrong Institute for Patient Safety and Quality regularly review all publicly available measures of safety and the methodology to determine a hospital’s Safety Grade. The National Expert Panel regularly convenes to review the methodology for validity and reliability. The scoring methodology is published in detail, and hospitals are given tools to analyze how their own grade was derived.
What is a "Straight A" hospital?
In fall 2025, there are 358 hospitals nationwide that not only achieved an “A” for fall 2025 but have sustained the Grade for more than two years, designating them “Straight A” hospitals. This select group, representing 13% of all eligible hospitals, is now highlighted on www.hospitalsafetygrade.org.
Are hospitals more likely to earn an "A" if they are part of a health system?
A Leapfrog analysis found that 90% of hospitals with a fall 2025 Safety Grade are part of a health system. Among A hospitals, the chance of being system affiliated is slightly higher, at 94%. Further research is needed to better understand this trend, as many independent hospitals, including rural and safety net facilities, also continue to earn “A” Grades.
Should patients avoid a “C,” “D,” or “F” hospital? What should people do if the only hospital in their community is a “C,” “D,” or “F?”
The Hospital Safety Grade website gives people free access to all the information used to evaluate each hospital, so people should study the Grade as well as other ratings and information and decide for themselves where to seek care. In some cases, the only hospitals available in a community do not have high Safety Grades. Leapfrog offers guidance and resources on our website for patients and family members to protect themselves during a hospital stay, which is important no matter the hospital’s Grade. It’s also important to communicate to hospital leaders, clinicians and boards your concern about the Grade and request information on what the hospital is doing to improve. Leapfrog has seen these kinds of inquiries have a significant impact in improving hospital performance.
Employers founded The Leapfrog Group in 2000 to improve patient safety. How can they use the Leapfrog Hospital Safety Grade?
Employers use the Hospital Safety Grade in two ways. First, employers can educate and inform their employees about the Hospital Safety Grade and the importance of considering patient safety when choosing a hospital. Second, employers can structure the way they pay for health care to reward excellence in safety. For instance, higher-graded hospitals might earn contract incentives. Visit Leapfrog’s free Employer Value Toolkit website for resources and information on where to start.
Who is The Leapfrog Group?
The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. For 25 years, we have served as the nation’s leading independent advocate of health care transparency to drive major improvement in patient safety, rating health care facilities to help people make informed, lifesaving decisions about where to seek services and giving purchasers tools to tie their purchasing strategy to excellence in safety and quality.