Hospital watchdog ordered to delete bad safety grades in Florida. Here’s why
A Florida judge has ordered a national watchdog to scrub poor patient safety grades for several South Florida hospitals, describing the scoring methodology as misleading and harmful for patients and “punitive” for medical centers that declined to participate in the voluntary surveys.
The decision made in West Palm Beach federal court March 6 is a defeat for the Leapfrog Group and a win for Good Samaritan Medical Center in West Palm Beach, Delray Medical Center, Palm Beach Gardens Medical Center, West Boca Medical Center and St. Mary’s Medical Center in West Palm Beach.
The ruling orders, among other things, for Leapfrog to remove its website safety grades for the Palm Beach County hospitals, going as far back as fall 2024.
“This ruling validates what hospitals across the country have experienced firsthand: Leapfrog is an organization built on deceptive and unfair practices that harms the very same patients it claims to serve. We brought this lawsuit because patients deserve transparency,” Maggie Gill, eastern group president of the Palm Beach Health Network, which includes the hospitals named in the suit, said in a statement.
“Hospitals should no longer be coerced into participating in a rating system or subjected to so-called ‘Safety Grades’ based on made-up data,” she said. “We hope this decision leads to meaningful changes nationwide, so that hospitals are no longer subjected to Leapfrog’s deceptive grading system and pressure tactics.”
Leah Binder, Leapfrog Group’s president and CEO, said the nonprofit plans to appeal the court’s decision, describing it as a threat to the “First Amendment rights of every American.”
“If this decision was allowed to stand, the implications would seriously undermine all published ratings and reviews in all industries, not just Leapfrog’s ratings of the safety of hospitals,” Binder said in a statement. “The decision gives businesses in Florida the right to sue ratings organizations if they feel harmed by a rating of their product. Ratings everywhere are potentially at risk now, from Amazon to Experian to Moody’s to Yelp.”
What was the Leapfrog lawsuit about?
The Palm Beach County hospitals, owned by Tenet Healthcare, sued Leapfrog last year, accusing the nonprofit of crafting misleading safety rankings that endanger patients as part of a “brazen pay-to-play scheme.”
Leapfrog has denied the allegations, stating it doesn’t charge hospitals to submit a survey and also doesn’t offer “any paid services to hospitals seeking to increase their grades.”
Hospital executives told the court there’s been a decrease in patients since it began receiving D’s and F’s from Leapfrog after it stopped participating in its survey. They said some patients even refused treatment at the hospitals, which have won awards and recognitions for medical care, because of the recent grades.
The Leapfrog Group, a nonprofit that has analyzed hospital data for more than 20 years, gives A to F grades to hospitals nationwide twice a year for patient safety, including hospitals across Miami-Dade, Broward and other parts of Florida. It grades nearly 3,000 hospitals across the country “on the very basics of medical care, such as hand-washing, entering prescriptions through a computer, and the availability of highly trained nurses.”
The nonprofit said it uses more than 20 factors, including rates of preventable errors, injuries and infections to help patients pick the best hospital near them for care. Some of the collected data is voluntarily reported by hospitals to Leapfrog, and other data is collected from other sources such as from the federal Centers for Medicare and Medicaid Services.
The Palm Beach County hospitals that sued the nonprofit are part of the for-profit Tenet Healthcare company. Tenet Health also owns ambulatory surgery centers, urgent care centers and imaging centers across Florida, including Miami-Dade and Broward counties.
What did the judge decide in the Leapfrog suit?
But U.S. Judge Donald Middlebrooks of the Southern District of Florida took issue with how the nonprofit calculates and publicly displays the data to the public. In his 41-page order, Middlebrooks said the “grades are not based upon performance” and “are the result of Leapfrog’s acknowledged goal of punishing nonparticipants as a means of forcing hospitals to cooperate in submitting their Surveys.”
He agreed with the Palm Beach County hospitals that Leapfrog’s practices were unfair and deceptive, in violation of state law.
He said Leapfrog’s methodology assigns non-participating hospitals the lowest score possible, a move that was “deliberately designed to coerce participation through reputational penalty, rendering the Methodology not merely strategic but excessively punitive” toward hospitals that declined to participate in the voluntary survey. He described it as a pressure tactic to make more hospitals participate in its survey, which in turn, increases Leapfrog’s ability to make more money off the data. Leapfrog sells licenses to its data to hospitals, researchers and businesses. Its website states the fee pays for the cost of the Survey and Safety Grade. Results are available online for free.
The judge believes the public grades are presented in a way that can mislead patients, employees, prospective employees and health insurers, who he said would reasonably interpret the grades as an accurate representation of hospital performance, not based on inputted scores.
The hospitals “have adequately shown a range of harms including patient diversion and delay of care, physician concerns, insurer inquiries, and declines in patient volume,” Middlebrooks wrote, noting that “the only beneficiary of this methodology is the Leapfrog itself. This tradeoff is simply not worth undermining trust in publicly disseminated safety information, even if it has the potential to encourage some hospitals to participate.”
South Florida hospitals have given Leapfrog a mix of praise and criticism through the years.
Jackson Health, Miami-Dade’s public hospital system, and Broward Health, one of the public hospital systems in Broward County, for example, have previously described the grades to the Miami Herald as a useful tool that provides valuable insight for growth and improvement. Other health systems, including HCA Florida, which owns hospitals across the state, and Mount Sinai Medical Center in Miami Beach, have criticized the group’s grading methodology.
“The recent court ruling raises important questions about the methodology used to assign Leapfrog safety grades, particularly the practice of penalizing hospitals that did not participate in a voluntary survey,” Gino Santorio, president and CEO of Mount Sinai, said in an email to the Miami Herald. “For hospitals like Mount Sinai, that means past Leapfrog scores did not accurately reflect our actual safety performance.”
Mount Sinai, which doesn’t participate in Leapfrog’s survey, has disputed the poor scores it received in recent years from Leapfrog despite the awards and recognitions the hospital has earned from other organizations for its medical care.
“Patients rely on hospital safety ratings to make some of the most important healthcare decisions of their lives, so those ratings must be accurate and based on complete data,” Santorio said. “We encourage patients to consider multiple independent measures of hospital quality when researching care.”
What Leapfrog says
Binder, Leapfrog’s president and CEO, disputes the judge’s decision, describing the nonprofit’s process as “the most transparent rating 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.”
“If Leapfrog’s gold-standard transparency is considered “deceptive” in Florida, no ratings system is safe from court intervention,” Binder said in her statement. She said the group will comply with the injunction in the meantime while it appeals the decision and said it will still release its upcoming spring 2026 grades as planned, “with some modifications based on the injunction which will be shared in the coming days.”
“Leapfrog has fought for over 25 years for health care transparency, which saves lives from errors, accidents, injuries, and infections in hospitals,” Binder added. “Make no mistake, that battle continues in full force —for South Florida and every community in America. We will never stop fighting for patients.”
This story was originally published March 10, 2026 at 12:50 PM.
