Samsung Medical Center (SMC) has suffered a major setback, being the first of the nation's five largest tertiary hospitals to be excluded from the government's top-tier ranking in the medical quality assessment, a local news report said.

According to Chosun Ilbo, a vernacular newspaper, this is the first case where a hospital among the so-called “Big 5” hospitals -- Seoul National University Hospital, Asan Medical Center, St. Mary's Seoul Hospital, Severance Hospital, and SMC -- failed to achieve the highest rating since the government initiated the medical quality assessment.

The news report said SMC received a "Grade 1-B" rating, which is one step below the highest grade (Grade 1-A), in the Ministry of Health and Welfare's medical quality assessment late last year.

At the end of last year, a total of eight hospitals received the highest grade in the medical quality assessment, including the remaining four Big 5 hospitals, Gachon University Gil Hospital, Pusan National University Hospital, Ajou University Hospital, and Inha University Hospital, while 28 hospitals received a "Grade-1B" rating.

As a result of the downgrade, Chosun reported that SMC might see a huge cut in the medical quality assessment subsidy of up to 10 billion won ($7.5 million) it receives annually from the government.

The medical quality assessment measures the level of medical services provided by medical institutions to patients and evaluates and grades each medical institution.

The medical quality evaluation indicators are composed of six items -- patient safety and medical quality, public influence, medical delivery system, and support activities, research and development, and education and training.

Every year, the Ministry of Health and Welfare conducts a medical quality assessment for high-level hospitals and general hospitals nationwide and gives the top grade of Grade 1-A to eight institutions within the top 2 percent.