The best and worst states in Leapfrog Group’s Fall 2025 hospital grades

When it comes to patient safety, Utah continues to earn bragging rights in The Leapfrog Group’s report cards.

Utah once again ranked as the state with the highest percentage of A-rated hospitals in Leapfrog’s Fall 2025 hospital safety grades. The group released its new hospital safety grades earlier this week.

This is the fifth consecutive report where Utah has landed at the top. The Leapfrog Group releases its safety grades twice a year, in the spring and fall. Sixty percent of the state’s hospitals received an “A” in the fall report.

Leah Binder, president and CEO of The Leapfrog Group, praised Utah’s hospitals consistency in patient safety.

“That's very, very impressive,” Binder says. “They weren't always at the top, so I was very impressed with that.”

• Read more: For first time, Leapfrog Group rates health systems in hospital safety grades

Virginia ranked second, with more than half (53.5%) of the state’s hospitals receiving an A. Binder notes that Virginia is home to more hospitals than Utah.

“Virginia, again, is way up there, and that is very impressive, because they have a lot of hospitals,” Binder says.

“When you have a lot of hospitals, it's a little harder to get to a higher percentage. And Virginia has a lot,” she says.

Sean T. Connaughton, president and CEO of the Virginia Hospital & Healthcare Association, welcomed the recognition from The Leapfrog Group.

Connaughton said the state’s hospitals “collaborate and share insights and best practices on enhancing patient safety as part of our journey to make Virginia the healthiest state in the nation.”

New Jersey, another state with a lot of hospitals, finished third, with 52% of the state’s hospitals getting an A in safety grades.

“New Jersey has been in the top 10 pretty consistently,” Binder says.

• Read more: Grading hospital systems: How 10 health systems fared in Leapfrog Group's safety grades

Connecticut, which was fourth, was the only other state with half of its hospitals (50%) getting an A. North Carolina rounded out the top five, with 45.7% of its hospitals designated as A-rated.

Four states didn’t have any A-rated hospitals in the Leapfrog Group’s latest safety grades: Iowa, North Dakota, Vermont and Wyoming.

Binder says those states have been landing at the bottom. They didn’t have any A-rated hospitals in Leapfrog’s spring report.

“I am fed up with seeing Iowa, North Dakota, Vermont and Wyoming always at the bottom of the list,” Binder says. “Nationally, they just don't have any hospitals getting an A. And there's no excuse for it. Those are great states. They should be getting A's.”

“They're always down there,” she continued. “Very, very disappointing. And I think people in the states ought to be asking those hospitals what's going on. If you're on the board of one of those hospitals, why don't you ask them the question and ask to see the safety grade?”

Hospital board members should be focused on patient safety in their hospitals, and Binder says they should be reviewing the findings in Leapfrog’s reports, beyond just the letter grade.

“I would encourage anyone who's on a board of hospital and is curious about how they did on the safety grade, don't just look at the grade. Dig in. And that is part of your responsibility as a board member, it's a fiduciary responsibility to really steward the quality and safety of care for those patients, and you can do that by looking at the grade and asking the right questions … in the boardroom, or sitting with the CEO,” she says.

Top 10 states

These states had the highest percentage of A-rated hospitals in The Leapfrog Group’s Fall 2025 Hospital Safety Grades

Utah (60.7%)

Virginia (53.5%)

New Jersey (52.2%)

Connecticut (50%)

North Carolina (45.7%)

California (44.4%)

Rhode Island (44.4%)

Pennsylvania (43.5%)

Maine (42.9%)

South Carolina (41.2%)

Bottom 10 states

The states with the lowest percentage of A-rated hospitals in The Leapfrog Group’s fall report.

Nebraska (15%)

Alaska (14.3%)

New Mexico (11.1%)

South Dakota (11.1%)

Alabama (9.3%)

West Virginia (9.1%)

Iowa (None)

North Dakota (None)

Vermont (None)

Wyoming (None)