The chief executive officer of Pen Bay Medical Center said the administration and staff have been working hard to earn an A grade from a national organization.

Leapfrog, an organization founded in 2000 by large employers and other groups that pay for medical care, issues grades twice a year — spring and fall.

Pen Bay received a B grade for both the fall of 2017 and the spring of 2018 after a few years of straight A grades.

Mark Fourre, chief executive officer for Pen Bay, said Thursday that the hospital welcomes the work done by Leapfrog and takes its ratings seriously.

"We're working hard to get back to an A," Fourre said and expressed confidence that Pen Bay would earn an A when the next grades are issued in the fall.

He pointed out that even one incident can skew numbers at a hospital as small as Pen Bay. He said, for instance, that Leapfrog reported that the number of falls by patients was above average at Pen Bay. There was one patient who fell during the period reviewed by Leapfrog.

"That's one too many," he said and that there have been no further falls since the last reporting period.

The hospital executive said that Leapfrog heightens the bar for achieving an A grade and that Pen Bay's performance is not worsening but that it has simply not kept up with the increasing standards. He said that the hospital plans to meet that bar, however.

The Leapfrog Hospital Survey collects and transparently reports hospital performance, "empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions," according to the organization's website.

The Leapfrog Hospital Safety Grade, Leapfrog’s other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents and infections.

In regard to patient safety, the organization looks at infections, surgeries, practices to prevent errors, overall safety measures and the training and communications between medical staff.

In terms of safety issues, Pen Bay was below average for patients falling. Leapfrog's report about the hospital being above average for patients with bed sores was based on older information and newer statistics show no dangerous sores, Fourre said.

The review of surgical procedures reported that Pen Bay was above average in many of the categories, but average or below for causing a collapsed lung during surgery, serious breathing problems after surgery and development of blood clots.

For the infections review, Leapfrog had no information on Pen Bay's efforts to prevent the spread of Methicillin-resistant Staphylococcus aureus, which is a type of staph bacteria that is resistant to many antibiotics. Pen Bay scored above average for its responses to all other types of infections.

Pen Bay was above average for practices to prevent medical errors.

Leapfrog determined that Pen Bay had enough qualified nurses, good communications by doctors and nurses, and effective leadership to deal with safety issues.

Leapfrog does not have any survey results from Waldo County General Hospital in Belfast or Miles in Damariscotta. Fourre said that is because the hospitals are so small that numbers will not be statistically meaningful.

Maine Medical Center in Portland received a B, as did Eastern Maine Medical Center in Bangor and MaineGeneral Medical Center in Augusta.

Hospitals receiving A grades in Maine included Maine Coast Memorial Hospital in Ellsworth, Mid Coast Hospital in Brunswick, Mercy Hospital of Portland, Southern Maine Healthcare's Biddeford Center, York Hospital and Aroostook Medical Center in Presque Isle.

St. Joseph Hospital of Bangor and Central Maine Medical Center in Lewiston received C grades.

The Leapfrog Hospital Safety Grade used national performance measures from the Centers for Medicare & Medicaid Services, the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the American Hospital Association’s Annual Survey and Health Information Technology Supplement.

Correction: The initial version of the story incorrectly stated that Pen Bay had received an A in the fall of 2017. The hospital had received a B in the fall of 2017 as well, but did have A grades in the spring of 2017 and in both spring and fall of 2016.