10 health systems with the most ‘A,’ straight-‘A’ hospitals

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Of the 358 hospitals that have earned Leapfrog’s “A” safety grade for at least two consecutive years, 95% are part of a health system.

Of the 11 hospitals that have earned consecutive “A” safety grades from The Leapfrog Group since 2012, all are affiliated with health systems. 

“For the first time we’re looking at how consolidation impacts patient safety,” Leah Binder, president and CEO of The Leapfrog Group, said in a Nov. 13 news release. “We want to understand if system leadership accelerates patient safety or not.”

Here are the 10 health systems that have the highest number of hospitals earning Leapfrog’s fall 2025 “A” and straight-“A” grades — awarded to hospitals that maintained an “A” grade for more than two years in a row: 

SystemNumber of hospitals gradedNumber of “A” hospitalsNumber of straight-“A” hospitals
HCA Healthcare (Nashville, Tenn.)1635118
CommonSpirit Health (Chicago)944924
AdventHealth (Altamonte Springs, Fla.)442921
Kaiser Permanente (Oakland, Calif.)512712
Advocate Health Charlotte, N.C.)46241
Prime Healthcare (Ontario, Calif.)452411
Defense Health Agency (San Diego)2018
Lifepoint Health (Brentwood, Tenn.)45162
Northwell Health (New Hyde Park, N.Y.)22153
Sutter Health (Sacramento, Calif.)20153

Editor’s note: Military hospitals will be eligible to earn straight-“A status in 2026.

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