Roughly one in four U.S. hospital inpatients are harmed by preventable errors each year.
“A” hospitals are overwhelmingly part of large health systems, Leapfrog’s analysis finds.
Utah leads the nation in hospital safety—for the fifth grading cycle in a row
A lot of factors influence a hospital’s safety record, but being part of a larger health system appears to increase patient safety.
The Leapfrog Group has released its fall 2025 Hospital Safety Grade, a nationwide assessment that assigns every general hospital in the U.S. a letter grade — A, B, C, D, or F — based on how well they protect patients from medical errors, injuries, accidents, and infections.
These are harms that remain both common and largely preventable, affecting an estimated one in four hospital inpatients and contributing to as many as 250,000 deaths a year.
As Leapfrog marks its 25th anniversary, the organization is taking a deeper look at how health system consolidation may be influencing hospital performance and patient safety outcomes. Patients can see how hospitals in their area rank here.
Health systems dominate the top performers
In this year’s analysis, 90% of all graded hospitals were part of a larger health system. That figure climbed even higher among top performers:
94% of hospitals earning an A were system-affiliated.
95% of “Straight A” hospitals — those that have maintained an A for more than two years — belonged to health systems.
All 11 hospitals that have received an A in every grading cycle since 2012 were also system-affiliated.
Leapfrog defines a health system as a network of health care facilities managed or owned by a single parent organization. The group also highlighted the 10 systems with the highest numbers of A and Straight A hospitals. While the Defense Health Agency appeared among system leaders, it was not included in Straight A recognition because its hospitals have not been eligible for enough grading rounds; they will qualify beginning in 2026.
Leah Binder, president and CEO of The Leapfrog Group, said the milestone year prompted a closer look at the role of system leadership.
“We want to understand if system leadership accelerates patient safety or not,” Binder said. “Transparency has always been our hallmark, and understanding how consolidation affects patient outcomes is a natural next step.”
State rankings: Utah holds the lead again
Each grading cycle, Leapfrog also evaluates states based on the proportion of hospitals receiving an A. In the fall 2025 rankings:
Utah topped the list for the fifth consecutive cycle.
Virginia, New Jersey, Connecticut, and North Carolina rounded out the top five.
Four states — Iowa, North Dakota, Vermont, and Wyoming — had no A-rated hospitals this time.
These state-level findings highlight ongoing geographic disparities in hospital performance and patient safety, reinforcing the need for continued transparency and accountability in healthcare systems nationwide.