Court rules Leapfrog hospital safety grades ‘deceptive,’ orders removal of Tenet ratings
A federal judge in Florida has sided with Tenet Healthcare in its lawsuit against Leapfrog, a nonprofit group that issues grades to hospitals that purport to measure the quality of care delivery, pricing transparency and patient safety records. Five of the health system’s hospitals in South Florida took issue with the methodology associated with the scoring, filing a civil lawsuit in April 2025.
In a joint complaint, Good Samaritan Medical Center, Delray Medical Center, Palm Beach Gardens Medical Center, West Boca Medical Center and St. Mary’s Medical Center—all owned by for-profit Tenet—said they received low grades, all because they declined to submit voluntary reporting data to Leapfrog.
According to claims made in the lawsuit, Leapfrog changed the way it issued its A-to-F safety rankings in 2024, more heavily weighing four measures that relied on voluntary data submission that goes beyond the legally required reporting sent to the state and federal government.
This approach is tantamount to extortion, Tenet argued. The health system accused Leapfrog of violating consumer protection laws and operating a “brazen pay-to-play scheme,” made possible through the sale of “memberships” that pressure facilities to participate with the nonprofit’s analysis.
At least in part, a judge agreed. U.S. District Court for the Southern District of Florida Judge Donald M. Middlebrooks ordered Leapfrog to remove the five hospitals from its rankings, and in the future only issue grades that do not punish facilities for choosing not to share data with an unaffiliated third-party.
The court also ruled that the revised framework Leapfrog established to develop its ratings means that “grades are not based upon performance. The grades are the result of Leapfrog’s acknowledged goal of punishing nonparticipants as a means of forcing hospitals to cooperate in submitting their surveys.”
“Leapfrog’s change in methodology has no scientific basis, unfairly penalizes non-participating hospitals, and misrepresents hospital safety,” he wrote.
Middlebrooks added that the “record shows that Leapfrog’s conduct evinces the kind of ‘deceptive and bullying conduct’” that violates federal and state law, and the grades themselves could reasonably be viewed as defamatory.
He also agreed that Leapfrog appeared to be motivated by financial incentives when it chose to hold hospitals to the standards of its new procedures that gave priority consideration to those that agreed to share data as part of a paid membership.
“It appears that the goal to maximize revenue came at the cost of comprehensive and accurate safety grades,” the judge wrote. “The result is that various parties—the hospitals, their employees, the insurers and of course the patients themselves—were and are foreseeably injured.”
In addition to removing the Tenet hospitals from its safety grades report, Leapfrog was also ordered to notify its members that its ratings criteria were found to be unlawful.
On its website, Leapfrog calls its work a “public service,” one it has provided to people nationwide for more than 20 years.
Its annual hospital ratings report can be found by clicking here.
Tenet rejoices, Leapfrog vows to appeal
In a statement released on Sunday, the five plaintiff hospitals—which comprise the Palm Beach Health Network—praised the judge’s ruling.
“We are pleased that the court ordered meaningful relief. But this is bigger than five hospitals: any organization influencing life-and-death healthcare decisions must be transparent, data-based, and accountable,” the health system wrote. “We look forward to Leapfrog’s swift compliance with the court’s order, and encourage hospitals and the healthcare industry to review today’s decision carefully and insist on rating systems that are transparent, scientifically grounded, and fair.”
All five of the hospitals received very low grades, ranging from D to F.
In its own press release, Leapfrog said it “vehemently” disagreed with the ruling by the U.S. District Court, saying it “threatens the First Amendment rights of every American.”
“Leapfrog is the most transparent ratings system anywhere in the country, with every element of its methodology made public and accessible to a lay audience, with nothing hidden from the public as proprietary or otherwise unavailable,” the group wrote. “If Leapfrog’s gold-standard transparency is considered ‘deceptive’ in Florida, no ratings system is safe from court intervention.”
“While we intend to appeal, we will comply with the injunction in the meantime,” it added.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.