Understanding hospital safety grades and what they mean for you.
Hospital safety in the U.S. is evaluated by two independent organizations. Both are legitimate, but they measure different things — which is why they sometimes disagree.
Part of the CMS star rating system. Safety is one of five domains that contribute to the overall star rating (weighted at 22%). Focuses on hospital-acquired conditions: infections, surgical complications, falls, and medication errors. Based on claims data submitted to Medicare.
Updated annually as part of the overall star rating refresh.
Published by The Leapfrog Group, an independent nonprofit founded by large employers and healthcare purchasers. Leapfrog grades focus exclusively on patient safety using over 30 measures.
Excels at keeping patients safe from preventable harm.
Above-average safety performance with minor areas for improvement.
Average safety. Some measures need attention.
Below-average safety. Multiple areas of concern.
Significant safety concerns across multiple measures.
Leapfrog evaluates:
Infections
Surgical site infections, MRSA, C. diff, catheter infections
Problems with Surgery
Collapsed lungs, accidental cuts, dangerous blood reactions
Practices to Prevent Errors
Computerized ordering systems, ICU physician staffing, safe medication bar codes
Maternity Care
Early elective deliveries, episiotomy rates, C-section rates for low-risk pregnancies
Updated twice yearly (spring and fall releases).
About 70% of hospitals receive different grades from CMS and Leapfrog. This isn’t a mistake — it reflects different methodologies and data sources. CMS relies primarily on Medicare claims data. Leapfrog uses a combination of CMS data and its own hospital survey responses.
Example: Choosing Between Two Hospitals
Hospital A
$8,000
Hospital B
$6,500
Hospital B costs $1,500 less, but Hospital A has a significantly better safety record. Taco shows you both numbers so you can make the decision that’s right for you. There’s no single right answer — it depends on the procedure, your health, and your priorities.
Safety metrics are informational and do not constitute medical advice.