Two Detroit hospitals, both part of the Detroit Medical Center, have received “F” grades on patient safety in a recent report.

Detroit Receiving Hospital and Sinai-Grace Hospital got those grades in the report by the Leapfrog Group, which describes itself as a nonpartisan, nonprofit organization that serving as a patient watchdog.

The group says its grades reflect the ability of hospitals nationwide to keep patients safe and prevent them from contracting illnesses or conditions they did not have upon admission.

Bret Jackson, president and CEO of the Economic Alliance for Michigan, which collaborated with Leapfrog on the study, said the findings in the Detroit hospitals were concerning.

“There are some areas where they may even be the worst hospital in the country for a specific metric,” Jackson said.

The report rated the two DMC hospitals poorly in several critical areas, including surgical wounds that reopen, deaths from serious yet treatable complications, severe breathing problems, dangerous bedsores, patient falls and injuries, and harmful blood clots.

The Detroit Medical Center said the report’s findings painted an incomplete picture.

“Detroit Medical Center does not submit data or participate in the annual Leapfrog Hospital Survey. Grades are still published even though there is incomplete or dated information,” the medical center said in a statement to Michigan Public.

DMC did not respond to a followup question asking why it does not participate in the survey.

Jackson said DMC’s participation in the Leapfrog survey is not essential to the grading, as most of the metrics the report used come from the federal Centers for Medicare and Medicaid Services.

Jackson said he believes that ensuring patient safety starts with senior management.

“Leadership has to engage every single person — not just doctors and nurses, but also those who clean the rooms and work security. Everyone in the hospital must be committed to making it the safest and least harmful place for patients,” he said.

Jackson said the hospitals can improve their scores. He said he’s seen hospitals with D and F grades transform into A-grade facilities in a relatively short period and hopes for a similar turnaround at DMC.

One of President-elect Donald Trump’s key promises to the American public has been the mass deportation of undocumented immigrants.

In Michigan, tens of thousands of migrant workers and their dependents contribute significantly to the agriculture and food processing industries each year, according to the state health department.

Advocates say the mass deportation plan threatens not only the lives these individuals have built in the U.S., but also the workforce in states like Michigan, where they play a critical role in local economies.

Susan Reed, director of the Michigan Immigrant Rights Center, said deportations could drive up the cost of produce.

“Employers are very likely to face employer-focused raids, and I would expect that to impact prices as businesses struggle to replace a workforce that is either no longer migrating or no longer present in the community,” Reed explained.

The logistics of Trump’s deportation plan remain unclear, although he has stated he would rely on local law enforcement and the National Guard to carry out the operations. How this will unfold is uncertain, particularly given that local law enforcement agencies operate under a separate leadership structure and do not report directly to federal authorities.

Moreover, said Reed, many local communities have implemented protections to safeguard their vulnerable residents.

“Many local communities have adopted resolutions or ordinances stating that local resources can only be used to cooperate with immigration enforcement to the minimum extent required by law,” Reed said. “I certainly expect new federal laws or proposals aimed at forcing more cooperation. But for now, many local communities already have policies that limit cooperation with federal immigration enforcement.”

Despite these local protections, Reed said her office continues to field calls from concerned people in Michigan—both documented and undocumented—who worry that their lives will be upended once Trump returns to office.

“I’m hearing from my clients who are on the path to citizenship—some who have been granted asylum but don’t yet have a green card, others who have a green card but haven’t yet become citizens, and some who are citizens but are so traumatized by the process and by the rhetoric that they’re terrified of losing their status,” Reed said. “I try to reassure them, while being honest about the uncertainties ahead.”

While the future remains unclear, Reed emphasized that deportation is often described as a “civil death,” and said she advises vulnerable individuals to prepare for the worst—especially those whose children have birthright citizenship.

Reed said parents should have power of attorney, or, in Michigan, a delegation of parental authority, in place. She said this legal document can help ensure that children are not placed in the foster care system if their parents are deported.

She also recommends that parents obtain and keep updated passports for their U.S. citizen children.