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 most general hospitals in the U.S. It is 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. Hospital Safety Grades are updated twice annually, in the fall and spring, and are freely available to the public at hospitalsafetygrade.org.
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 250,000 people every year, the third leading cause of death in the United States. One in four people admitted to a hospital suffer some form of avoidable harm. And not all hospitals are the same; some are much safer than others.
Are there improvements across hospitals nationally, as seen in the spring 2026 Leapfrog Hospital Safety Grade?
Data from the spring 2026 Safety Grade show significant improvement across 17 measures related to errors and infections. These include healthcare-associated infections, medication errors, and five patient experience measures: nurse communication, doctor communication, staff responsiveness, communication about medications, and discharge information.
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 Hospital Safety Grade is a letter grade Leapfrog assigns twice each year to general hospitals in the United States. 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. In addition, some Leapfrog Hospital Survey ratings are used to calculate a Safety Grade.
Why are some hospitals reported as “Grade Not Assigned”?
For spring 2026, due to a ruling by a federal court in South Florida, Leapfrog is not assigning Safety Grades to 450 hospitals that did not participate in the 2024 or 2025 Leapfrog Hospital Survey. These hospitals are reported as Grade Not Assigned (GNA). Although the court ruling only applied to five hospitals, Leapfrog does not apply programmatic changes to individual hospitals because the Hospital Safety Grade is a national program. Leapfrog is pursuing an appeal and reviewing the Safety Grade methodology with its National Expert Panel to ensure the Hospital Safety Grade remains useful for consumers. Any proposed methodology changes will be announced and made available for public comment.
Why are some hospitals reported as “Not Graded”?
Some hospitals do not have enough patient safety data available to get a Safety Grade and are reported as “Not Graded.” Typically, this is because they have a smaller patient population, and performance measures cannot be calculated.
This is different from the designation “Grade Not Assigned.” Due to a ruling by a federal court in South Florida, Leapfrog is not assigning Safety Grades to hospitals that did not participate in the 2024 or 2025 Leapfrog Hospital Survey, and those 450 hospitals are designated as “GNA” on Leapfrog’s website.
See the spring 2026 methodology here for a full explanation of why a hospital might not be graded.
Why does my hospital not show up when searched?
Certain types of hospitals are not eligible for a Safety Grade, including critical access hospitals, long-term care and rehabilitation facilities, mental health facilities, federal hospitals such as VA and Indian Health Service hospitals, some specialty hospitals, including cancer hospitals, free-standing pediatric hospitals and hospitals in U.S. territories. Our experts are studying ways to rate them in the future.
How are measures selected for inclusion in the Safety Grade?
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 spring 2026, there are 372 hospitals nationwide that not only achieved an “A” for spring 2026 but have sustained the Grade for more than two years, designating them “Straight A” hospitals. This select group, representing 16% of all graded hospitals, is now highlighted on www.hospitalsafetygrade.org.
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 look at the Grade, the underlying data used to calculate it, and 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 about your concern about the Grade and to request information on what the hospital is doing to improve. Leapfrog has found that these kinds of inquiries have a significant impact on 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 their health care payments to reward safety excellence. For instance, hospitals with higher grades might earn contract incentives. Visit Leapfrog’s free Employer Value Toolkit website for resources and information on where to start.
What 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. Since our founding in 2000 by major employers and the Business Roundtable, we have served as the nation’s leading independent advocate of health care transparency and patient safety. Leapfrog publishes ratings of hospitals and ambulatory surgery centers to help people make informed, lifesaving decisions about where to seek care, and help employers and other purchasers of health benefits tie those benefits to excellence in safety and quality.