Dive Brief:
- Nonprofit watchdog organization The Leapfrog Group must remove the safety grades it assigned to five Tenet Healthcare hospitals after a federal judge ruled the grades were deceptive and unfair.
- Judge Donald Middlebrooks of Florida’s southern district court found that Leapfrog punished the hospitals for not voluntarily participating in its surveys by giving them failing or near-failing grades, according to the Friday ruling. According to hospital leaders, the deflated safety grades caused patients to avoid the facilities due to the perception of a higher risk of injury or death.
- Leapfrog said it plans to appeal the decision but will comply with the court order in the meantime. “We vehemently disagree with this decision, as we believe it threatens the First Amendment rights of every American,” the group said in a statement.
Dive Insight:
Leapfrog bills itself as a consumer watchdog group that aims to increase hospital safety transparency. The nonprofit publishes a set of hospital safety grades twice a year. Consumers can use Leapfrog’s website to search for facilities and get detailed information on measures that grade infections, safety problems, staffing, practices to prevent errors and more.
The group says that its ratings can be a matter of life and death. On its website, Leapfrog states that research has found patients are “twice as likely to die of a preventable problem at a C, D, or F hospital than an A hospital” and that “over 50,000 lives would be saved if all hospitals performed the way A hospitals did.” Patients “face a 92% greater risk of avoidable death” at facilities with “D” and “F” grades, the group said in 2019.
One metric informing Leapfrog’s safety grades is data from a voluntary survey that the group issues to hospitals. Facilities that opt not to participate in the survey have their grades based on alternative metrics. But scores for non-participating hospitals usually “do not fare well,” according to Friday’s order.
An additional change to Leapfrog’s methodology in 2024 made it “almost impossible” for hospitals that opted not to participate to receive a passing safety grade, Middlebrooks said.
“Put simply, the alternative scoring measures became punishing,” the order says.
Five Tenet-owned hospitals in Florida — Good Samaritan, Delray Medical Center, Palm Beach Gardens Medical Center, St. Mary’s and West Boca Medical Center — received poor grades starting in 2024 after opting not to participate in Leapfrog’s survey. Four of the hospitals received a failing “F” grade at some point between spring 2024 and fall 2025.
The grades represented a significant decline from prior years when the hospitals had participated in the survey. In 2021, the hospitals gained a total score of 370 out of 400 across the four measures, compared with a total score of 60 out of 400 following the updated methodology, according to the order.
Public perception of the hospitals fell as a result, according to testimony from the hospital administrators at trial.
One patient, recounted by Delray CEO Heather Havericak, initially declined surgery at Delray, fearing she would die at the hospital. Another patient at West Boca left the facility against the advice of clinicians after learning of Leapfrog’s safety grade, according to West Boca CEO Jerad Hanlon.
The hospitals filed a lawsuit against Leapfrog last year, arguing the safety grades unfairly penalized hospitals that declined to participate in the survey and constituted a deceptive business practice.
Middlebrooks agreed. Leapfrog’s methodology “has no scientific basis” and “misrepresents hospital safety,” he wrote in his order.
One of Leapfrog’s arguments — that hospitals opt not to participate in the survey in order to hide poor safety performance at their facilities — reflected a “certain hubris” on Leapfrog’s part, Middlebrook said.
Hospitals may decline to participate in Leapfrog’s survey for various reasons, especially because the survey is time intensive, according to testimonies at trial. The plaintiff hospitals first stopped participating in Leapfrog’s survey in 2021 during the COVID-19 pandemic after undergoing significant operational strain, hospital executives said.
In addition to removing its grades for the plaintiff hospitals, Leapfrog must send corrective disclosures to companies that paid to license the 2024 and 2025 grades, and correct future contracts and advertising materials, according to Middlebrook’s order.
In a statement, Leapfrog said it had “the most transparent ratings system anywhere in the country.”
“If this decision is allowed to stand, the implications would seriously undermine all published ratings and reviews in all industries, not just Leapfrog’s ratings of the safety of hospitals,” the group said.
