Hospital Safety Grades: What Do A, B, C, D, F Mean?
Hospital safety grades provide patients with an easy-to-understand assessment of how well hospitals protect patients from preventable harm. This guide explains the major safety grading systems and how to use them when choosing a hospital.
The Leapfrog Hospital Safety Grade
The most widely known hospital safety grading system is the Leapfrog Hospital Safety Grade, which assigns letter grades (A, B, C, D, or F) to general acute-care hospitals based on their ability to prevent medical errors, injuries, accidents, and infections.
What Each Grade Means
- A: The hospital has achieved the highest standard in patient safety measures
- B: The hospital performs well on most safety measures but has room for improvement
- C: The hospital's safety performance is average
- D: The hospital has significant room for improvement in patient safety
- F: The hospital has critical safety concerns that need immediate attention
How Leapfrog Calculates Grades
Leapfrog uses over 30 national performance measures from CMS, the Leapfrog Hospital Survey, and other sources. These measures fall into several categories:
- Healthcare-associated infections (CLABSI, CAUTI, SSI, MRSA, C.diff)
- Problems with surgery (collapsed lungs, surgical wounds reopening)
- Practices to prevent errors (computerized physician order entry, ICU staffing)
- Safety culture and response to errors
- Fall and injury prevention
CMS Safety Measures
CMS also provides safety-related data through Medicare Care Compare, including:
- Patient Safety Indicators (PSIs): Measures of potentially avoidable complications during hospital stays
- Healthcare-Associated Infection (HAI) rates: How often patients develop infections during their hospital stay compared to national benchmarks
- Safety of Care star rating: One of the five categories in the overall CMS star rating
How to Use Safety Grades
- Don't rely on grades alone: A hospital with a B grade in safety might be the best choice for your specific procedure
- Look at specific measures: If you're having surgery, focus on surgical complication rates rather than the overall grade
- Check trends: A hospital improving from C to B may be more focused on safety than one that has always been a B
- Consider context: Some hospitals serve higher-risk patients, which can affect certain measures
- Compare multiple sources: Check both Leapfrog grades and CMS safety data for a complete picture
Where to Find Safety Information
- Medicare Care Compare for CMS quality and safety data
- The Leapfrog Group website for hospital safety grades (updated twice yearly, spring and fall)
- Your state health department for additional safety data and inspection reports
Data sourced from CMS and The Leapfrog Group. Visit Medicare Care Compare or call 1-800-MEDICARE for hospital quality data.
Disclaimer: This article is for informational purposes only and does not constitute medical advice.
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.
Related reading
Hospital Accreditation: Joint Commission vs DNV vs HFAP
Hospital accreditation is a process through which healthcare organizations are evaluated against established standards
What Is a Critical Access Hospital? A Patient Guide
If you live in a rural area, the closest hospital may be a Critical Access Hospital (CAH). These small, specially designated
How Often Are Hospital Ratings Updated?
Hospital quality ratings are not static — they are updated periodically as new data becomes available. Understanding the update