For the first time in its 14-year history, The Leapfrog Group’s biannual safety grades update omitted hospitals that did not participate in its surveys.
The change affects more than 20% of hospitals that would otherwise be graded and comes as the result of a lawsuit filed by Palm Beach (Fla.) Health Network, a division of Dallas-based Tenet Healthcare.
In March, U.S. District Judge Donald Middlebrooks ruled that Leapfrog’s 2024 methodology change — which altered how it weighted scores for nonparticipating hospitals — unfairly penalizes nonparticipating hospitals by assigning them artificially low scores with no scientific basis.
While the judge ordered Leapfrog to withdraw only Palm Beach Health Network’s five hospitals from its safety grades for fall 2024, spring 2025 and fall 2025, the organization opted to remove all 450 nonparticipating hospitals.
“Although the court ruling only applied to five hospitals, Leapfrog does not apply programmatic changes to individual hospitals because the Hospital Safety Grade is a national program,” the organization said in a May 6 news release.
Leapfrog, which is appealing the ruling, said it expects to resume full grading in fall 2026.
Maggie Gill, eastern group president at Palm Beach Health Network, said the ruling and spring safety grade withdrawals have implications that extend far beyond the system’s five hospitals named in the lawsuit.
“Nearly 500 hospitals will not have unfair and deceptive grades inaccurately calculated and publicized,” she said in a May 5 statement to Becker’s. “This goes way beyond one lawsuit — there are real consequences to Leapfrog’s misleading grades and pressure tactics.”
Palm Beach Health Network filed suit in April 2025 after three of its hospitals received “F” grades and two received “D” grades. The lawsuit alleged the new methodology gave its hospitals unfairly low scores. The court sided with the hospitals, ruling that they “have adequately shown a range of harms, including patient diversion and delay of care, physician concerns, insurer inquiries and declines in patient volume” from the grades, the judge said.
“In healthcare, published ratings can influence patient choice, physician behavior and payer decisions,” Ms. Gill said. “If those ratings are going to carry weight, they have to be accurate.”
Leapfrog has defended its safety grades, noting the organization has advocated for patient safety transparency for more than 25 years.
Leapfrog is “reviewing the Safety Grade methodology with its National Expert Panel to ensure the Hospital Safety Grade continues to be useful for consumers,” the group said. “Any proposed methodology changes will be announced and made available for public comment.”
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