The title of "Best Hospital" in the United States goes to ... The Johns Hopkins Hospital. Again

The Baltimore-based Johns Hopkins earned the top spot among about 5,000 hospitals in the United States for the 22nd year, according to U.S. News and World Report's 2011-2012 rankings released on Tuesday. It has earned the top spot every year since the U.S. News Media Group began publishing the annual list in 1990.

The latest report recognized 720 hospitals of 4,825 nationwide that rank among the best in their metro area or in at least one of 16 medical specialties.

This year only 140 of the total number of hospitals evaluated performed well enough in even one medical specialty to earn a national ranking, according to the U.S. News media release Tuesday.

The list covers all 94 metro areas that have a minimum of both 500,000 residents and one hospital that performed well enough to earn a place, as well as 16 medical specialties, from cancer and heart disease to urology and respiratory disorders.

The rankings derive from statistics in these specialties, such as fatality rates, patient safety and volume of procedure. They also rely on a national survey in which physicians named the hospitals they consider best in their specialty for the toughest cases.

Johns Hopkins earned the top spot of 17 "Honor Roll" hospitals given the distinction for "rare breadth and depth of medical excellence," according to U.S. News.

In 2010-2011, 152 hospitals made the rankings cut but only 14 placed on the honor roll for high scores in six or more of the total 16 specialties.

This year Massachusetts General Hospital in Boston overtook the Mayo Clinic for the number two spot with the Rochester, Minnesota-based clinic taking third.

Brigham and Women's Hospital, also in Boston, traded places with Barnes-Jewish Hospital at Washington University Medical Center of St. Louis, moving up three spots to eighth while Barnes-Jewish dropped to 11th.

Vanderbilt University Medical Center in Nashville, Mount Sinai Medical Center in New York, and Stanford Hospital & Clinics of California all joined the 2011-2012 honor roll list.

The mission of "Best Hospitals" is to serve as a guide for patients in need of a high level of care, according to the U.S. News report.

"These are referral centers where other hospitals send their sickest patients," Avery Comarow, U.S. News Health Rankings Editor, said in Tuesday's statement.

"Hospitals like these are ones you or those close to you should consider when the stakes are high."