A federal judge ruled March 6 that The Leapfrog Group’s Hospital Safety Grades for five Florida hospitals constitutes “an unfair and deceptive business practice,” finding Leapfrog deliberately punished the hospitals for not participating in its voluntary survey by assigning them artificially low scores with no scientific basis.
Under the ruling, Leapfrog must withdraw the five hospitals’ safety grades for fall 2024, spring 2025 and fall 2025 from its websites and send corrective disclosures to all entities that paid to license those grades.
The ruling breaks precedent for the patient safety organization that assigns biannual safety scores to U.S. hospitals, from “A” to “F” grades. Hospitals have pushed back on Leapfrog’s safety grades for years, arguing that the methodology is flawed and unfairly penalizes hospitals that don’t participate. Two other hospitals have made similar allegations in lawsuits since 2017, but separate courts dismissed or denied those cases.
Five hospitals in Palm Beach (Fla.) Health Network, which is a division of Dallas-based Tenet Healthcare, filed the most recent lawsuit April 30, 2025, after three of the hospitals received an “F” grade and two earned a “D.”
The lawsuit alleged methodology Leapfrog implemented in 2024 penalizes hospitals that do not participate in its national surveys, claiming the low scores unfairly damaged the hospitals’ reputations. A Florida judge agreed.
In his ruling, U.S. District Judge Donald Middlebrooks said Leapfrog assigned “arbitrarily low scores for several measures” and changed the weighing on those measures for nonparticipating hospitals, according to court documents.
The hospitals “have adequately shown a range of harms, including patient diversion and delay of care, physician concerns, insurer inquiries and declines in patient volume” from these grades, the judge said.
Mr. Middlebrooks ordered Leapfrog to:
- Stop assigning a safety grade to these five hospitals through a methodology that “assigns assumed or imputed values,” scores nonparticipating hospitals differently than participating hospitals or reduces a hospital’s safety grade for not providing performance data
- Withdraw the safety grades for these five hospitals for fall 2024, spring 2025 and fall 2025
- Disclose to all entities that paid to license its fall 2024, spring 2025 and fall 2025 safety grades that the grades “were found to be deceptive and unfair”
“This ruling validates what hospitals across the country have experienced firsthand: Leapfrog is an organization built on deceptive and unfair practices that harms the very same patients it claims to serve,” said Maggie Gill, president of Palm Beach Health Network’s eastern group. “Hospitals should no longer be coerced into participating in a rating system or subjected to so-called ‘Safety Grades’ based on made-up data.”
In a March 8 statement, Leapfrog President and CEO Leah Binder said the organization disagrees with the court’s decision and plans to appeal.
“We cannot accept the decision’s main conclusion, that Florida citizens — and all Americans — don’t have a right to hear Leapfrog’s expert perspective on how well these five for-profit, Tenet-owned hospitals care for patients,” the statement said.
“If Leapfrog’s gold-standard transparency is considered ‘deceptive’ in Florida, no ratings system is safe from court intervention,” according to Ms. Binder.
Ms. Binder said Leapfrog will comply with the order to remove the five hospitals’ safety grades from fall 2024, spring 2025 and fall 2025. She added the March 6 ruling undermines “all published ratings and reviews in all industries,” including ratings on Amazon, Experian, Moody’s and Yelp, and violates the First Amendment.
Editor’s note: This article was updated at 4 p.m. Central Time to include comment from Palm Beach Health Network.
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