6 states with no Leapfrog 'A'-rated hospitals

The number of states — plus Washington, D.C. — without an "A"-rated hospital by Leapfrog increased from three to seven in less than two years.

Since 2012, Leapfrog has assigned grades to nearly 3,000 acute-care general hospitals across the nation every fall and spring. The grades evaluate hospitals' performance on up to 22 patient safety measures from CMS, the Leapfrog Hospital survey and other sources. The grades are the only hospital ratings program based solely on hospitals' ability to protect patients from preventable errors, accidents, injuries and infections. Read more about Leapfrog's methodology here

In fall 2022, only three states — North Dakota, Vermont and Washington, D.C. — had no "A" hospitals. But a year later, five states had no "A" hospitals.

The most recent rankings added two states to the list — West Virginia and South Dakota — bringing the total to seven states without an "A"-ranked hospital.

Meanwhile, 18 states saw increases in their respective percentages of "A" hospitals between fall 2023 and spring 2024. Utah, which has the highest percentage of "A" hospitals, went from 51.9% in fall 2023 to 57.7% in spring 2024.

Here are the states with no "A" hospitals in the spring 2024 rankings:


North Dakota

South Dakota


Washington, D.C.

West Virginia


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