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Leapfrog’s Fall 2025 Hospital Safety Grades Link Top Marks to Health System Affiliation

The findings spotlight system-level influence on patient safety, fueling debate over methodology.

Overview

  • Leapfrog released updated grades for nearly 3,000 U.S. general hospitals using 22 safety measures drawn from federal data and its voluntary survey.
  • Roughly 90% of graded hospitals are in health systems, and system affiliation applies to 94% of A hospitals and 95% of Straight A hospitals, with all 11 all-time Straight A facilities system-based.
  • Utah led state rankings for the fifth straight cycle, followed by Virginia, New Jersey, Connecticut and North Carolina, while Iowa, North Dakota, Vermont and Wyoming had no A hospitals.
  • HCA logged the most A hospitals at 51, trailed by CommonSpirit (49), with AdventHealth, Kaiser Permanente, Advocate Health, Prime Healthcare, the Defense Health Agency, Lifepoint, Northwell and Sutter also posting large A totals.
  • A federal lawsuit by five Tenet-owned Florida hospitals challenging Leapfrog’s ratings remains underway, as methodology changes that score nonrespondents lowest in certain categories and a total of 23 F grades draw added scrutiny.