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Dive summary:
- Nonprofit watchdog organization The Leapfrog Group must remove the safety ratings it assigned to five Tenet Healthcare hospitals after a federal judge ruled the ratings were misleading and unfair.
- Judge Donald Middlebrooks of Florida’s Southern District Court found that Leapfrog punished hospitals for not voluntarily participating in its surveys by giving them failing or near-failing grades, according to Friday’s ruling. According to hospital leaders, low safety ratings caused patients to avoid the facilities due to a perceived higher risk of injury or death.
- Leapfrog said it plans to appeal the decision but in the meantime he will comply with the court order. “We strongly disagree with this decision, as we believe it threatens the First Amendment rights of all Americans,” the group said in a statement.
Diving information:
Leapfrog bills itself as a consumer watchdog group that aims to increase transparency in hospital safety. The nonprofit organization publishes a set of hospital safety ratings twice a year. Consumers can use Leapfrog’s website to search for facilities and get detailed information about infection triage measures, safety issues, staffing, error prevention practices, and more.
The group says its ratings It could be a matter of life or death.. On its website, Leapfrog states that research has found that patients are “twice as likely to die from a preventable condition in a C, D, or F hospital than in an A hospital” and that “more than 50,000 lives would be saved if all hospitals operated as A hospitals did.” Patients “face a 92% higher risk of preventable death” in facilities with grades “D” and “F”the group said in 2019.
One metric that informs Leapfrog’s safety ratings is data from a voluntary survey the group sends to hospitals. Ratings for facilities that choose not to participate in the survey are based on alternative metrics. But non-participating hospitals’ scores typically “do not fare well,” according to Friday’s order.
A further change to Leapfrog’s methodology in 2024 made it “nearly impossible” for hospitals that opted out to receive a passing safety rating, Middlebrooks said.
“Simply put, the alternative scoring measures became punitive,” 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 ratings as of 2024 after opting out of Leapfrog’s survey. Four of the hospitals received a failing grade of “F” sometime between spring 2024 and fall 2025.
The ratings represented a significant decrease from previous years when hospitals had participated in the survey. In 2021, hospitals earned a total score of 370 out of 400 on all four measures, compared to a total score of 60 out of 400 following the updated methodology, according to the order.
As a result, public perception of the hospitals fell, according to testimony from hospital administrators at trial.
One patient, recounted by Delray CEO Heather Havericak, initially refused surgery in Delray for fear of dying in the hospital. Another West Boca patient left the facility against doctors’ advice after learning how safe Leapfrog was, according to West Boca CEO Jerad Hanlon.
The hospitals filed a lawsuit against Leapfrog last year, arguing that the safety ratings unfairly penalized hospitals that refused 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 out of the survey to hide poor safety performance at your facilities – reflected a “certain arrogance” on Leapfrog’s part, Middlebrook said.
Hospitals may refuse to participate in Leapfrog’s survey for several reasons, especially because the survey is time-consuming, according to testimony at trial. Plaintiff hospitals stopped participating in Leapfrog’s survey for the first time in 2021 during the COVID-19 pandemic after experiencing significant operational strain, hospital executives said.
In addition to eliminating its grades for the plaintiff hospitals, Leapfrog must send corrective disclosures to the 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 rating system in the country.”
“If this decision is allowed to stand, the implications would seriously undermine all published ratings and reviews across all industries, not just Leapfrog’s ratings on hospital safety,” the group said.
