Leapfrog Hospital Safety Grades: How to Read and Use the Results
The Leapfrog Group's Hospital Safety Grade is one of the most widely used tools for evaluating how well hospitals protect patients from preventable harm. Published every spring and fall, these letter grades give patients a clear, accessible way to assess hospital safety performance.
Understanding the A-to-F Grading System
Leapfrog assigns each hospital a letter grade that reflects its overall safety performance:
- Grade A: Hospital demonstrates the highest standards of patient safety with strong protocols to prevent errors and infections
- Grade B: Good safety performance with minor areas for improvement
- Grade C: Average safety performance with notable areas needing attention
- Grade D: Below-average safety with significant concerns in one or more areas
- Grade F: Serious patient safety deficiencies requiring immediate attention
The 27 Safety Measures Behind the Grade
Each grade is calculated from 27 measures spanning several categories:
- Healthcare-associated infections (5 measures): CLABSI, CAUTI, SSI for colon surgery and hysterectomy, MRSA, and C. diff rates
- Surgical problems (7 measures): Retained surgical items, air embolism, blood incompatibility, falls, pressure ulcers, collapsed lung from procedures, and accidental cuts
- Safety practices (8 measures): Computerized physician ordering, ICU physician staffing, nurse staffing, safe medication administration, hand hygiene, and communication protocols
- Doctor and nurse communication (7 measures): HCAHPS survey responses about staff responsiveness and communication quality
How Patients Can Use Safety Grades
Safety grades are most useful when combined with other quality information:
- Search your hospitals at hospitalsafetygrade.org
- Compare the safety grade with the CMS star rating on Medicare Care Compare
- Review the detailed safety measure scores, not just the overall grade
- Consider safety grades alongside your physician's recommendation and the hospital's expertise in your specific condition
- Track grade changes over time to identify improving or declining hospitals
Limitations to Keep in Mind
While valuable, safety grades have some limitations patients should understand:
- Not all hospitals receive grades due to insufficient reporting data
- Grades may lag behind real-time quality improvements at individual hospitals
- Small hospitals may have more variable scores due to smaller patient populations
- Specialized hospitals (children's, psychiatric, rehabilitation) are not graded
Data sourced from The Leapfrog Group. Grades are published biannually. Visit hospitalsafetygrade.org for current results.
Disclaimer: This article is informational and does not replace professional medical advice. Discuss hospital options with your healthcare provider.
Important
This article explains how hospital quality data works and is for general information only. It is not medical advice and must not be used to decide whether to seek, delay or refuse care — that is a decision for you and a clinician who knows your situation.
CMS quality measures describe care delivered during earlier reporting periods and are refreshed roughly quarterly. A hospital's staffing, services and performance can change well before the published numbers do.
hospiguide.org is not affiliated with, endorsed by, or connected to CMS, Medicare, or any U.S. government agency, and publishes no ratings of its own.
Before acting on anything here, verify current details at Medicare.gov Care Compare or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
HospiGuide.org Editorial Team
Our editorial team explains U.S. hospital quality data using official CMS datasets and government publications. We are not medical professionals, we do not recommend hospitals, and we accept no payment for coverage. Every factual claim is checked against a CMS or federal source. Read our editorial policy.
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