Eleven of 28 Connecticut hospitals in a newly released safety report card received an A rating, the top grade available.

The Leapfrog Group report card gave hospitals across the country letter grades from A to F with the latter being the worst grade available. None of the hospitals in Connecticut received a grade any lower than a C with the latest round of report cards.

The following hospitals received an A grade on the report card: Hartford Hospital, Middlesex Hospital in Middletown, MidState Medicial Center in Meriden, Saint Mary's Hospital in Waterbury, Sharon Hospital, St. Vincent's Medical Center in Bridgeport, Stamford Health, The Hospital of Central Connecticut in New Britain, William Backus Hospital in Norwich, UConn Health in Farmington and Windham Community Memorial Hospital.

Of the 11 hospitals that received A as a grade, six are owned by Hartford HealthCare.

"Our hospitals perform a lot of really complicated procedures," Dr. Ajay Kumar, chief clinical officer for the health care network, said. "And once you have achieved that grade, it's a challenge to sustain that level of performance."

Vincent Capece Jr., president and chief executive officer at Middlesex Hospital, said the Middletown-based facility "spends a lot of time and effort to make sure we provide the safest possible care for our patients." The hospital, one of several independent health care facilities in the state, received an A grade from the Leapfrog report card.

"Safety is job one," Capece said, adding that Middlesex Hospital has received an A grade on every report card since Leapfrog started the ratings. "There are more and more patients that are becoming savvy about where they receive their care. And I know that providers, everybody is in the industry is looking at this and trying to raise the bar."

Five hospitals received B grades. They were: Bristol Health, Charlotte Hungerford Hospital in Torrington, Greenwich Hospital, Johnson Memorial in Stafford Springs and Norwalk Hospital.

Officials with Yale New Haven Health said in a statement that the health care organization "is committed to providing the safest and highest quality of care." Yale New Haven Hospital received a "C" grade of the safety report card.

"We are also committed to transparency and we provide Leapfrog with our quality data that helps inform the grades," the statement said in part. "The Leapfrog grades depend on data that are at least a year old and do not capture all of the important elements of patient safety. Nevertheless, we anticipate that our many recent initiatives in our continuous pursuit of patient safety will be reflected in future ratings."

Yale New Haven performed worse than the average hospital in three of six categories focused on preventing infections and three of seven categories regarding problems associated with surgery. Many of the hospitals receiving a "C" grade on the report card had a worse than average grade in the preventing infections and problems with surgery categories.

In addition to Yale New Haven Hospital, the following hospitals received "C" grades: Bridgeport Hospital and its Milford campus, Danbury Hospital, Day Kimball Hospital in Putnam, Griffin Hospital in Derby, Lawrence + Memorial Hospital in New London, Manchester Memorial Hospital, New Milford Hospital, St. Francis Hospital & Medical Center, Waterbury Hospital and Yale New Haven's Saint Raphael campus.

Yale New Haven Health officials on Friday announced that it is suing Prospect Medical Holdings to get out of the deal it made to purchase of Manchester Memorial, Rockville General and Waterbury hospitals. Yale New Haven Health's lawsuit contends that Prospect breached its contract with Yale by defaulting on rent and tax liabilities, allowing its facilities to deteriorate, mismanaging assets, "driving away" physicians and vendors and engaging in "a pattern of irresponsible financial practices."

The Leapfrog Group was founded in 2000 by large employers and other purchasers and is an independent national nonprofit organization driving a movement for giant leaps for patient safety. The organization issues its report cards twice a year and bases its grades on more than 30 indicators from the federal government and its own survey of hospitals.

The report cards look at rates of preventable errors and infections; how well hospitals follow procedures, such as hand washing, which is known to improve patient outcomes; and whether they have adequate staffing, among other factors.

Angela Mattie, a professor of management and medical sciences at Quinnipiac University, said the Leapfrog hospital safety report card "is a very simple to understand method of viewing how care is delivered at hospitals." Mattie is on the Trinity Health of New England quality and safety committee and once served as a Leapfrog fellow.

"The fact that we have quality and safety measures available to the public is a good thing," Mattie said. "It helps spur on accountability to make improvements. Hospital boards need to take this data seriously and ask what senior management is doing to improve these grades."

Every hospital "should be striving for an A on the safety report card," she said.

"We need to make sure we have a safe, high quality care at the lowest possible cost," Mattie said "And right now, there's plenty of room for improvement in that regard."

Some of the 12 hospitals that received C grades on the latest report card had fared better in previous reviews.

Day Kimball Hospital received an A grade in report cards issued to in 2021 and 2022. The hospital received a B last fall and fell to a C this spring.

Massachusetts-based Covenant Health canceled its plan to acquire Day Kimball Hospital in March 2023.