How is the Leapfrog Hospital Safety Grade calculated?

It uses up to 22 national patient-safety measures from CMS and the Leapfrog Hospital Survey, plus supplemental data, combined into one A-F grade. The measures are split into two domains — Process/Structural and Outcome — each worth 50%. Grades are updated twice a year, in spring and fall.

Compare the rankings

U.S. News Best Hospitals vs. Leapfrog Hospital Safety Grade

Q: What is the difference between U.S. News Best Hospitals and the Leapfrog Safety Grade?

U.S. News ranks hospitals for specialty excellence using patient outcomes, care-related measures, and a physician reputation survey. The Leapfrog Hospital Safety Grade rates how well a hospital protects patients from preventable harm — errors, accidents, injuries, and infections — as a single A-F letter grade. One measures excellence in complex care; the other measures safety.

Q: How often is each updated?

U.S. News Best Hospitals is published once a year (typically mid-year). The Leapfrog Hospital Safety Grade is published twice a year, in spring and fall.

By the Shield Tracker team Published June 4, 2026 Reflects the 2025–26 programs

The short answer

U.S. News Best Hospitals ranks hospitals for specialty excellence, using patient outcomes, care-related measures, and a physician reputation survey. The Leapfrog Hospital Safety Grade rates how well a hospital protects patients from preventable harm — errors, accidents, injuries, and infections — as a single A–F letter grade, updated twice a year. One asks “is this among the best for complex care?” The other asks “how safe is this hospital?”

What each one is

U.S. News Best Hospitals is an annual ranking of specialty excellence — 15 ranked adult specialties plus 22 High Performing procedures and conditions — designed to help patients with complex needs find strong programs.

The Leapfrog Hospital Safety Grade is a free, twice-yearly rating from The Leapfrog Group focused entirely on patient safety: how well a hospital prevents medical errors, accidents, injuries, and infections. It is published at hospitalsafetygrade.org as a single letter grade from A to F.

Side-by-side comparison

	U.S. News Best Hospitals	Leapfrog Safety Grade
Measures	Specialty excellence / complex care	Patient safety / preventable harm
Output	Rankings + High Performing ratings	One letter grade (A–F)
Run by	U.S. News & World Report	The Leapfrog Group (nonprofit)
Reputation survey?	Yes (one weighted part)	No
Main inputs	Outcomes, care measures, reputation	Up to 22 safety measures (CMS + Leapfrog Survey)
Updated	Once a year	Twice a year (spring & fall)

How the Safety Grade is built

Per The Leapfrog Group, the grade uses up to 22 national patient-safety measures drawn from CMS and the Leapfrog Hospital Survey, plus supplemental data, combined into one score. The measures are organized into two equally weighted domains:

Process / Structural measures (50%) — whether the hospital has safe practices and systems in place.
Outcome measures (50%) — rates of infections, injuries, and other preventable harms.

The methodology is public and peer-reviewed, overseen by a National Expert Panel.

Why a hospital can do well on one and not the other

Because they ask different questions. A renowned academic center can rank highly with U.S. News for complex specialty care yet receive a middling Leapfrog grade if specific safety measures (for example, certain infection or process metrics) lag — and a community hospital with strong safety practices can earn an “A” without appearing in any U.S. News specialty ranking. Both perspectives are valid and complementary.

Which matters for whom

Patients weighing where to go for a complex procedure may look to U.S. News; those focused on safety may check the Leapfrog grade.
Hospital quality and safety teams watch Leapfrog closely because it is actionable and updates twice a year; marketing and strategy teams track U.S. News for specialty reputation.
Leadership often has to reconcile the two publicly when they disagree.

Frequently asked questions

What is the difference between U.S. News and the Leapfrog Safety Grade?

U.S. News ranks specialty excellence using outcomes, care measures, and a reputation survey. Leapfrog rates how well a hospital protects patients from preventable harm as a single A–F grade. One measures excellence in complex care; the other measures safety.

How is the Leapfrog grade calculated?

From up to 22 CMS and Leapfrog Hospital Survey safety measures, split into Process/Structural and Outcome domains (50% each), combined into one A–F grade, updated twice a year.

Why can a top U.S. News hospital get a low Leapfrog grade?

They measure different things. U.S. News rewards specialty and complex-case excellence and includes reputation; Leapfrog focuses narrowly on preventable harm and safety processes, so a hospital can be strong on one and weaker on the other.

How often is each updated?

U.S. News Best Hospitals once a year; the Leapfrog Hospital Safety Grade twice a year, in spring and fall.

Know where you stand — in the rankings you’re measured on

Shield Tracker helps hospital teams manage their U.S. News Best Hospitals data submission and track their own scores, High Performing ratings, gaps, year-over-year trends, and peer benchmarking across every service line.

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Sources

The Leapfrog Group, “Hospital Safety Grade — Scoring Methodology.” hospitalsafetygrade.org
U.S. News & World Report, “FAQ: How and Why We Rank and Rate Hospitals.” health.usnews.com

Independence & trademarks. Shield Tracker is an independent software product. It is not affiliated with, endorsed by, or sponsored by U.S. News & World Report or The Leapfrog Group. “U.S. News & World Report” and “Best Hospitals” are trademarks of U.S. News & World Report L.P.; “Leapfrog” and “Hospital Safety Grade” are trademarks of The Leapfrog Group. All are used here descriptively for education and commentary. Details reflect the publicly described 2025–26 programs and are subject to change.

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