The Leapfrog Group appealed a Florida judge’s March ruling Sept. 10, seeking to reverse an order that forced the patient safety watchdog to pull grades for five hospitals that declined to complete its surveys.
The hospitals are part of Palm Beach (Fla.) Health Network, a division of Dallas-based Tenet Healthcare. They sued Leapfrog in April 2025 after three of the hospitals received an “F” safety grade and two earned a “D.” On March 6, U.S. District Judge Donald Middlebrooks ruled in favor of the health system, finding that Leapfrog penalizes hospitals that do not participate in its national surveys.
In its spring 2026 safety grades, released in May, Leapfrog chose to not grade the five Florida hospitals and about 450 others. A month later, Mr. Middlebrooks denied Leapfrog’s request to reconsider the case.
On Sept. 10, the organization filed its opening brief with the 11th U.S. Circuit Court of Appeals, asking the court to reverse the judgment, according to court documents reviewed by Becker’s. The appeal rests on three arguments: that Leapfrog’s safety grades are constitutionally protected opinion, that the injunction is an unconstitutional prior restraint on speech, and that Florida’s Deceptive and Unfair Trade Practices Act does not reach a nonprofit’s reporting on matters of public concern.
At issue is how Leapfrog scores hospitals that skip its survey. When a hospital does not report data on four measures — computerized physician order entry, bar-code medication administration, ICU physician staffing and hand hygiene — Leapfrog assigns a “Limited Achievement” score, the lowest value earned by a participating hospital. The district court found that approach deceptive and unfair, ordering Leapfrog to stop grading the hospitals under it “or any similar methodology” and to withdraw the grades from its website.
“As with most speech on matters of public concern, there are some — particularly hospitals that receive poor grades — that fault Leapfrog’s methodology and grades,” the brief said. Leapfrog has graded U.S. acute care hospitals, from “A” to “F,” twice a year since 2012.
The hospitals have sought $10.5 million in attorneys’ fees and costs, a sum Leapfrog said exceeds its annual revenue. Mr. Middlebrooks denied that request without prejudice, pending the outcome of the appeal.
A spokesperson for Palm Beach Health Network told Becker’s the system is confident the appellate court will uphold the district court’s ruling.
“Having lost after a full trial on that factual record, Leapfrog now seeks to recast its misleading Safety Grades as ‘protected opinion’ — effectively admitting those scores are not fully grounded in real facts,” Palm Beach Health Network said. “Leapfrog cannot avoid accountability by labeling their scores as opinion ratings that it falsely presents to patients and the public as grounded in data and hospital safety.
“Leapfrog’s Safety Grades are flawed and misleading and they have been caught deceiving the public,” the organization said. “What they do is harmful to hospitals, doctors, other caregivers and patients, and we will continue to fight for the transparency and accuracy that patients deserve.”
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