10 health systems with the most ‘A,’ straight-‘A’ hospitals
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:
| System | Number of hospitals graded | Number of “A” hospitals | Number of straight-“A” hospitals |
| HCA Healthcare (Nashville, Tenn.) | 163 | 51 | 18 |
| CommonSpirit Health (Chicago) | 94 | 49 | 24 |
| AdventHealth (Altamonte Springs, Fla.) | 44 | 29 | 21 |
| Kaiser Permanente (Oakland, Calif.) | 51 | 27 | 12 |
| Advocate Health Charlotte, N.C.) | 46 | 24 | 1 |
| Prime Healthcare (Ontario, Calif.) | 45 | 24 | 11 |
| Defense Health Agency (San Diego) | 20 | 18 | – |
| Lifepoint Health (Brentwood, Tenn.) | 45 | 16 | 2 |
| Northwell Health (New Hyde Park, N.Y.) | 22 | 15 | 3 |
| Sutter Health (Sacramento, Calif.) | 20 | 15 | 3 |
Editor’s note: Military hospitals will be eligible to earn straight-“A status in 2026.
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