Methodology

For the report, Leapfrog assigned "A" to "F" letter grades to nearly 3,000 general acute-care hospitals using up to 22 evidence-based measures of patient safety, including data from CMS Medicare PSI 90 Patient Safety and Adverse Events composite.

The ratings, which are updated twice a year, do not cover facilities such as military or VA hospitals, critical access hospitals, specialty hospitals, children's hospitals, or outpatient surgery centers.

How hospitals performed

In the latest report, Leapfrog found that the states with the highest percentage of A grades were:

• Utah
• Rhode Island
• New Jersey
• Connecticut
• South Carolina
• Virginia

Utah ranked number one for the fourth consecutive Safety Grade Round. Meanwhile, Washington, D.C. ranked 11th for percentage of A hospitals in spring 2025, marking a notable improvement after years of ranking lowest in the country.

Leapfrog also found there were no A hospitals in Iowa, North Dakota, Vermont, or Wyoming.

The five states with the highest share of Straight A hospitals since spring 2023 were:

• Utah (29%)
• Connecticut (29%)
• New Jersey (27%)
• Rhode Island (22%)
• Virginia (20%)

Meanwhile, the states with no Straight A hospitals include:

• Alaska
• Delaware
• Hawaii
• Iowa
• North Dakota
• Nebraska
• New Mexico
• Nevada
• South Dakota
• Vermont
• West Virginia
• Wyoming
• Washington, D.C.

Leapfrog also recognized an "elite group" of 11 hospitals that have earned As for all 27 grading rounds, which cover 13 years. These "all-time Straight A" hospitals are:

• Endeavor Health Elmhurst Hospital* (Illinois)
• French Hospital Medical Center (California)
• Inova Loudoun Hospital* (Virginia)
• Kaiser Permanente Orange County-Anaheim Medical Center* (California)
• Mayo Clinic-Phoenix* (Arizona)
• Northwestern Medicine Central DuPage Hospital* (Illinois)
• Saint Anne's Hospital (Massachusetts)
• Sentara CarePlex Hospital* (Virginia)
• Sentara Leigh Hospital* (Virginia)
• University of Chicago Medical Center* (Illinois)
• Virginia Mason Medical Center (Washington)

*Indicates an Advisory Board member

"All hospitals should be proud to earn an 'A,' but they should not rest on that laurel. Patient safety is a relentless, never-ending quest to put patients first," Binder said. "That's why Leapfrog is highlighting the hospitals across the U.S. that have earned Straight A's for over two years. Sustaining an A over multiple years reflects a deep-rooted commitment to patient safety."