How to Check Hospital Safety Ratings Before Your Baby’s Birth

When you’re preparing to deliver your baby, choosing the right hospital matters deeply. Beyond location and insurance coverage, understanding how hospitals measure up on safety and quality can help protect both you and your newborn during one of life’s most vulnerable moments. Hospital safety ratings provide concrete data on how well facilities prevent complications, infections, and errors, but these report cards can feel overwhelming when you’re already managing the stress of pregnancy and planning for delivery.

This guide explains the major hospital rating systems, what they actually measure, and how New York families can use them alongside other factors to make informed decisions about where to give birth.

What Are Hospital Safety Ratings and Why Do They Matter for Birth?

Hospital safety ratings are standardized scores that evaluate how well hospitals protect patients from preventable harm. Think of them as report cards that summarize a hospital’s performance on measurable outcomes like infection rates, complication rates, patient deaths, and adherence to evidence-based medical protocols.

For families expecting a baby, these ratings matter because they reflect real-world safety practices. A hospital with strong safety ratings typically has systems in place to prevent common but serious birth complications, lower rates of hospital-acquired infections in mothers and newborns, better staffing levels for maternity units, and established protocols for recognizing and responding to emergencies during labor and delivery.

Major rating systems compile data from federal programs, independent safety organizations, and voluntary hospital surveys. While no single rating tells the complete story, together they provide valuable insight into which hospitals consistently protect patients and which ones struggle with preventable errors.

How Does the CMS Star Rating System Evaluate Hospitals?

The Centers for Medicare & Medicaid Services (CMS) assigns each hospital an Overall Hospital Quality Star Rating between 1 and 5 stars. This rating synthesizes approximately 45 different quality measures organized into five main categories:

• Mortality (death rates for common conditions)
• Safety of care (complications, infections, and injuries)
• Readmissions (whether patients return to the hospital soon after discharge)
• Patient experience (survey responses about communication, pain management, and care quality)
• Timely and effective care (whether hospitals follow evidence-based treatment protocols)

The first four categories each count for 22% of the overall score, while timely and effective care accounts for 12%. CMS uses statistical methods to standardize these measures and then applies a clustering algorithm to sort hospitals into star categories.

You can look up any hospital’s CMS star rating on the Medicare Care Compare website, which also shows specific performance data on complications, readmissions, and patient satisfaction scores. This federal database updates regularly and covers nearly all U.S. hospitals, making it one of the most comprehensive resources available.

What Is the Leapfrog Hospital Safety Grade?

The Leapfrog Hospital Safety Grade takes a different approach by focusing specifically on patient safety rather than overall quality. This independent rating assigns hospitals letter grades from A to F based on how likely patients are to suffer preventable harm during their stay.

Leapfrog evaluates hospitals using 22 to 32 evidence-based safety measures drawn from both CMS data and its own voluntary hospital survey. These measures fall into two equally weighted categories. Process and structural measures examine whether hospitals have the right systems in place, such as safe medication practices, appropriate nurse staffing levels, and established safety protocols. Outcome measures track actual harm events like patient falls, healthcare-associated infections, surgical complications, and dangerous blood clots.

Hospitals that fully meet Leapfrog’s standards on a measure receive the highest possible score (typically 100 points for “Achieved the Standard”), while partial achievement results in lower scores. The organization releases updated grades twice a year, giving families current information about hospital safety performance.

Unlike the CMS star rating, which balances safety with other quality factors, the Leapfrog grade zeroes in exclusively on preventing medical errors and patient harm. For families concerned about birth injuries, this narrow focus can be particularly valuable.

Where Can I Find New York Hospital Quality Information?

New York State maintains its own Hospital Profiles website that lets you compare hospitals across the state on metrics especially relevant to childbirth and newborn care. This resource includes hospital-specific data on patient satisfaction scores, emergency department wait times and efficiency, childbirth practices and outcomes, complication rates, infection rates acquired during hospitalization, death rates for specific conditions, and readmission rates.

The state system also tracks detailed maternity care measures through the Statewide Perinatal Data System, which feeds data into the Health Data NY portal. You can find information about cesarean section rates, early elective delivery rates (deliveries before 39 weeks without medical necessity), severe obstetric complications, and NICU transfer rates for different hospitals.

New York’s hospital profiles complement federal ratings by providing state-level context and additional measures that matter for maternal and newborn care. The site also includes hospital inspection results and information about whether facilities have specialized capabilities like high-level NICUs for premature or critically ill newborns.

What Safety Measures Matter Most for Labor and Delivery?

When evaluating hospitals for childbirth, certain safety metrics directly relate to maternal and newborn outcomes. Major rating systems track several measures particularly relevant to preventing birth injuries.

Risk-adjusted mortality rates show whether mothers or babies die at expected rates given the complexity of cases the hospital treats. Hospitals with lower-than-expected mortality rates generally have better systems for managing emergencies and complications.

Hospital-acquired infection rates measure how often patients develop new infections during their stay. For maternity care, this includes surgical site infections after cesarean delivery and bloodstream infections that can lead to serious complications like sepsis.

Complication rates track preventable problems like severe bleeding after delivery, dangerous blood clots, significant tears during vaginal delivery, and injuries to mothers during cesarean sections. Lower complication rates typically indicate better surgical technique, appropriate use of interventions, and adequate staffing.

Readmission rates show how often mothers return to the hospital within 30 days of giving birth, which can signal inadequate initial care or missed complications. Patient experience scores from HCAHPS surveys reveal how well staff communicate, manage pain, explain medications, and respond to concerns, all of which affect safety because clear communication prevents errors.

Evidence-based practice measures confirm whether hospitals follow established protocols for safe delivery, such as avoiding unnecessary early deliveries, using appropriate fetal monitoring, and having clear pathways for managing emergencies like shoulder dystocia or postpartum hemorrhage.

What Do Hospital Safety Ratings Leave Out?

While safety ratings provide valuable data, they have important limitations families should understand. These systems primarily rely on administrative data and insurance claims, which can lag by a year or more. A hospital’s current rating reflects past performance and may not capture recent improvements or new problems.

Rating systems don’t fully adjust for social and economic factors that affect patient outcomes. Hospitals serving low-income communities or patients with complex medical and social needs may have lower ratings not because of poor care quality but because their patients face additional health risks that aren’t fully accounted for in statistical adjustments.

The metrics also can’t capture every type of harm. Rare but serious complications may not show up in the data, and some quality dimensions like how well hospitals handle specific emergencies are difficult to measure through standard reporting systems.

Different rating organizations use different methodologies, weightings, and data sources, which explains why a hospital might receive high marks from one system and lower grades from another. The CMS star rating, for example, balances safety with efficiency and patient experience, while Leapfrog focuses purely on preventing harm. Neither is wrong, but they measure different things.

Research shows that while rating methodologies allow for reasonably stable hospital comparisons over time, they reflect statistical and policy choices that can affect a hospital’s score independent of actual bedside care quality. Understanding these limitations helps families use ratings appropriately as one information source among several.

How Should I Use Safety Ratings When Choosing a Birth Hospital?

Public health experts recommend treating safety ratings as one important tool in a broader decision-making process rather than the sole factor in choosing where to deliver. Start by looking up hospitals in your area on Medicare’s Care Compare website for CMS star ratings, check the Leapfrog Hospital Safety Grade site for current safety grades, and review New York’s Hospital Profiles for state-specific quality data and maternity measures.

Beyond ratings, consider factors these systems don’t capture fully. Hospital volume for deliveries matters because facilities that handle more births typically have more experienced staff and better-developed protocols for managing complications. Specialist availability is crucial, particularly access to maternal-fetal medicine specialists, experienced anesthesiologists, and neonatologists who can respond quickly to emergencies.

NICU level makes a difference if you have risk factors for preterm birth or other complications. Level I nurseries provide basic newborn care, Level II can handle moderately ill babies, Level III have comprehensive NICU capabilities including ventilators and subspecialists, and Level IV offer the highest level of surgical and specialty care. Delivering at a hospital with the right NICU level for your situation can prevent risky transfers after birth.

Practical considerations like insurance network participation, distance from home, and visitor policies also matter for your overall experience and access to support during labor and postpartum recovery.

For families with high-risk pregnancies or known complications, prioritize hospitals with strong performance specifically on maternal and newborn safety measures. Look for lower rates of severe obstetric complications, established practices for managing your particular risk factors, and appropriate specialty services.

What Specific Maternity Safety Data Should I Review?

When comparing hospitals for childbirth, dig deeper into maternity-specific measures beyond overall ratings. The CMS Provider Data Catalog includes a dedicated maternal health section with hospital-level data, and New York’s Hospital Profiles break down childbirth practices and outcomes in detail.

Key metrics to review include cesarean section rates for first-time mothers with low-risk pregnancies (rates significantly above 25% may indicate overuse), early elective delivery rates before 39 weeks without medical indication (this practice increases risks for babies and should be rare), severe maternal morbidity rates measuring life-threatening complications like hemorrhage, sepsis, or shock during delivery, hospital-acquired infection rates for mothers after cesarean delivery, and episiotomy rates for vaginal deliveries (overuse of this procedure can cause complications).

For newborn safety, look at rates of birth trauma like fractures or nerve injuries during delivery, unexpected complications in full-term newborns, need for transfer to higher-level NICU care, and rates of early-term births before 39 weeks.

New York participates in several maternal safety initiatives, and some hospitals voluntarily report additional quality improvement efforts. The state’s perinatal data system tracks these measures across facilities, allowing meaningful comparisons between hospitals serving similar patient populations.

Why Do New York Hospitals Have Lower Average Safety Ratings?

Recent analyses show that New York’s hospitals average around 2.5 out of 5 stars on the CMS rating system, placing the state near the bottom nationally despite having some of the country’s highest healthcare spending. Relatively few New York hospitals earn 4 or 5 stars, while a significant share receive 1 or 2 stars.

This persistent quality gap reflects multiple factors. New York hospitals serve diverse patient populations with complex medical and social needs, which affects risk-adjusted outcomes even with statistical controls. The state has a large number of small and medium-sized hospitals that may lack the resources and patient volumes that support higher quality scores. Some hospitals in underserved areas face workforce challenges, staffing shortages, and financial pressures that impact their ability to meet all quality benchmarks.

However, lower state averages don’t mean all New York hospitals perform poorly. The state has excellent facilities that rank among the nation’s best on safety measures, particularly some of the major medical centers and hospitals affiliated with academic institutions. The variation within the state makes it especially important for New York families to research individual hospitals rather than making assumptions based on overall state statistics.

The state government and healthcare organizations recognize these quality challenges and have implemented various improvement initiatives focused on maternal and infant health, but progress takes time to show up in rating systems that rely on historical data.

How Can I Combine Ratings With Other Information?

The most informed decision comes from synthesizing multiple sources rather than relying solely on any single rating or review. Start with the objective data from CMS stars, Leapfrog grades, and New York Hospital Profiles to identify hospitals with strong track records on safety and quality measures relevant to childbirth.

Then layer in information the ratings don’t capture. Talk to your obstetrician or midwife about where they have admitting privileges and their experiences with different hospitals’ labor and delivery units. Ask specific questions about staffing patterns (like whether there’s 24/7 anesthesia coverage and in-house OB coverage), how the hospital handles common emergencies during delivery, and whether they support your preferences for birth while maintaining flexibility for medical necessity.

If you’re touring hospitals before delivery, observe the maternity unit environment and ask about nurse-to-patient ratios, available pain management options, policies on newborn care and rooming-in, and how they involve families in decision-making. Request information about the hospital’s quality improvement initiatives, especially any focused on reducing cesarean rates, preventing infections, or improving maternal safety.

Connect with other families through local parenting groups, birth classes, or online communities to hear about recent experiences, but weigh anecdotal reports alongside objective safety data. Individual stories reflect important aspects of care quality like communication and respect, but they can’t show statistical patterns in outcomes.

For high-risk pregnancies, consider consulting a maternal-fetal medicine specialist who can recommend hospitals equipped to handle your specific medical situation, even if that means traveling farther from home for delivery.

Hospital safety ratings give you valuable, evidence-based information to help choose where your baby will be born, but they work best as part of a comprehensive evaluation. By combining CMS star ratings, Leapfrog safety grades, and New York’s Hospital Profiles with information about hospital capabilities, your provider’s experience, and your personal medical needs, you can make a more informed decision. Remember that the highest-rated hospital overall may not always be the best fit for your specific situation, so weigh safety data alongside specialist availability, NICU capabilities, insurance coverage, and practical factors. No hospital is perfect, but choosing one with strong safety performance on maternity measures stacks the odds in favor of a healthy outcome for both you and your baby.

If you want to view any New York Hospital’s safety ratings combined with other factors, NYBirthInjury.com has a comprehensive database of New York Hospitals offering obstetrics services.