Leapfrog appeals ruling against its hospital safety grades, citing its First Amendment right to free speech

The Leapfrog Group, a nonprofit that grades hospitals in an effort to measure care quality and patient safety records, is appealing a ruling from a U.S. District Court in South Florida that found its methodology to be “deceptive” and barred it from ranking five Tenet hospitals.

Tenet, a for-profit healthcare system in this case represented by Good Samaritan Medical Center, Delray Medical Center, Palm Beach Gardens Medical Center, West Boca Medical Center and St. Mary’s Medical Center, filed its initial complaint against Leapfrog in April 2025.

The group of hospitals claimed they received low grades, all because they declined to submit voluntary reporting data to Leapfrog. Further, it was alleged the nonprofit changed its methodology in 2024, more heavily basing its A-to-F grades on this enhanced data reporting, which goes beyond what the hospitals send to the state and federal government.

In siding with the Tenet facilities, Judge Donald M. Middlebrooks wrote that Leapfrog’s grading system “unfairly penalizes non-participating hospitals, and misrepresents hospital safety,” ordering the nonprofit to remove the grades for all five hospitals from its website.

Middlebrooks added in his ruling that Leapfrog was in violation of federal and state law, and that the grades could inherently be viewed as defamatory. He also questioned Leapfrog’s motivations for prioritizing hospitals that engaged in data sharing, something they did as part of membership agreements that Tenet called a “brazen pay-to-play scheme.”

“It appears that the goal to maximize revenue came at the cost of comprehensive and accurate safety grades,” the judge wrote in his March 2026 decision. “The result is that various parties—the hospitals, their employees, the insurers and of course the patients themselves—were and are foreseeably injured.”

Leapfrog complied with the order, removing grades for roughly 450 hospitals that did not participate in the enhanced data sharing. But it denied any wrongdoing, writing in a statement that its ratings are the “most transparent,” 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.”

“If Leapfrog’s gold-standard transparency is considered ‘deceptive’ in Florida, no ratings system is safe from court intervention,” it added, vowing to appeal the ruling.

Middlebrooks denied a motion to appeal in June.