Five Tenet hospitals will have their safety grade removed by Leapfrog

The Leapfrog Group was ruled against by a federal judge in a case filed by hospitals in Tenet Healthcare subsidiaries, which alleged they were punished for not voluntarily submitting data to the hospital safety grading nonprofit.

The decision revolves around one of the methodology changes that Leapfrog had already made before its hospital safety grades were released this fall. The method focuses more on the imputed scores for four of 32 safety measures, which Leapfrog assigns when the latest safety statistics for the two previous years are unavailable.

This is a deliberate failure and defamation of the hospitals that did not submit their data to Leapfrog, the alleged plaintiff hospitals, with the claim that they had suffered because of their poor grades.

One of the judges concurred and, in his decision, directed Leapfrog to withdraw its low grades on the five plaintiff hospitals that comprise the Palm Beach Health Network and not to award grades to the hospitals via its current or similar methodology. All its paid licensees should also receive disclosures concerning the decision of the court, that the change in its methodology proved to be deceptive and unfair, violating Florida law.

The switch in methodology adopted by Leapfrog does not have scientific justification, and it unfairly punishes non-participating hospitals, as well as falsely represents the state of hospital safety, Judge Donald M. Middlebrooks of the U.S. District Court of the Southern District of Florida wrote.

In April 2025, the plaintiffs had sued the parties after several letters had been exchanged between them, where Leapfrog had dismissed the demand of Tenet to stop and desist the publication of the ratings against such hospitals. All of them had been graded either F or D by Leapfrog.

In a press statement following the verdict, Palm Beach Health Network stated that they were happy the Court had ordered substantial relief. However, this is larger than five hospitals: any organization that affects life-and-death healthcare decisions should be transparent, data-based, and accountable. We hope that Leapfrog will promptly adhere to the order of the Court, and urge hospitals and the healthcare sector to examine the current ruling thoroughly and demand a system of ratings that is open, scientifically based, and fair.

In an interview, Leah Binder, CEO of Leapfrog, said that the organization would abide by the injunction given by the court but would appeal.

Most of the legal changes being held constant, Leapfrog will proceed with the spring 2026 publication of the hospital safety grades and leave out those five hospitals and all the other hospitals affected by the imputation methodology, since we do not select and choose hospitals for different methodologies. You have one methodology on the safety grade of every hospital, she said, and I shall give you more.

The next ratings issue in the fall, she added, will be rated in a different way that would enable us to rate those five hospitals and all the hospitals in the United States, since this is our mission of hospital safety transparency.

In his decision, the judge stated that the evidence at trial did not support a dispositive fact that the four measures charged are the foundation of a meaningful difference in grade of a hospital, yet indicated that a number of factors argue in favor of the fact that indeed the low ratings are causing worse outcomes.

In his analysis under the law of Florida, he asserted that the characterization of the grades of Leapfrog is a complete and true description of the safety of the patients, which was a false statement by Leapfrog to the consumers.

He also concurred with the plaintiffs that bad ratings were detrimental to the reputation of the plaintiffs with patients and other people, and he found persuasive the evidence and testimony indicating that some of the actions taken by Leapfrog before and after the ratings were placed were done to coerce the hospitals to participate, which was in the best financial interest of the group.

The judge stated that it seemed that the maximization of revenue was at the expense of detailed and correct Safety Grades. The outcome of this is that the different sides (the hospitals, their employees, the insurers, and, of course, the patients themselves) were injured foreseeably.

Binder claimed that her organization was outraged and fiercely opposed to the ruling of the judge, and it literally went in opposition to some of the findings.

She claimed that the witnesses that Leapfrog invited to the court had testified that the scores that the methodology attributed were a usual practice in ratings institutions, and that the ruling did not affect the scores of the five hospitals negatively. And, though the judge had pointed out that the change had not been voted on by the advisory board on which Leapfrog consults in its approach to changes in its practices, she had indicated that such boards never vote, but made decisions by consensus, which had previously been arrived at by such boards when she herself had formally approved of the change.

In a larger sense, Binder asserted that the judge who decides to consider hospitals as consumers under the Florida law creates extremely worrying implications for any organization rating or reviewing businesses.

To push it further: a credit rating agency that rates a business as having a credit rating of Moody, and receives a downgrade, would have a case, in the view of this judge, to sue under this Florida statute, in that they have suffered due to a rating. It has no evidence at trial that that was the proper interpretation of this law, so with chilling consequences to the First Amendment, certainly, and to the power of any organization to rate and criticize businesses as well.

Leapfrog Safety Grades Removed After Court Ruling

A federal judge has ordered The Leapfrog Group to remove safety grades assigned to five hospitals owned by Tenet Healthcare. The ruling concluded that the Leapfrog grading methodology unfairly penalized hospitals that chose not to participate in its voluntary safety survey.

The hospitals, part of Palm Beach Health Network in Florida, received poor ratings from Leapfrog, including “D” and “F” grades. The court determined that these Leapfrog scores could mislead patients because they were based on assumed or imputed data rather than actual performance metrics.