Judge Orders Leapfrog to Remove Safety Grades for 5 Tenet Hospitals

Leapfrog plans to appeal the ruling, which found its methodology change was "deceptive and unfair" under Florida law.

Published on Mar. 9, 2026

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A federal judge has ruled against the Leapfrog Group in a lawsuit brought by Tenet Healthcare subsidiary hospitals. The judge ordered Leapfrog to remove the poor safety ratings it had assigned to five Tenet hospitals, finding that Leapfrog's 2024 methodology change that more heavily weighted 'imputed' safety scores for non-participating hospitals was "deceptive and unfair" under Florida law.

Why it matters

The ruling raises questions about the transparency and fairness of hospital safety rating systems, and whether organizations that rate businesses can be sued by those businesses under certain state laws. Leapfrog says the decision has "extremely disturbing ramifications" for any group that rates or reviews businesses.

The details

The lawsuit was filed in 2025 by five Tenet Healthcare hospitals that had received 'F' or 'D' grades from Leapfrog. They argued Leapfrog's methodology change unfairly punished them for not voluntarily submitting safety data. The judge agreed, finding Leapfrog's characterization of its grades as fully accurate representations of patient safety were "deceptive" and that the goal to "maximize revenue came at the cost of comprehensive and accurate Safety Grades."

  • The lawsuit was filed in April 2025.
  • The federal judge's ruling was handed down on March 9, 2026.

The players

Leapfrog Group

A nonprofit organization that publishes hospital safety grades and ratings.

Tenet Healthcare

A large for-profit hospital operator that owns the five hospitals involved in the lawsuit against Leapfrog.

Judge Donald M. Middlebrooks

The federal judge who ruled against Leapfrog in the lawsuit.

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What they’re saying

“Leapfrog's change in methodology has no scientific basis, unfairly penalizes non-participating hospitals, and misrepresents hospital safety.”

— Judge Donald M. Middlebrooks, U.S. District Court Judge

“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.”

— Palm Beach Health Network

“To take that to another level: a business that gets a credit score from Moody's and gets downgraded would have standing, according to this judge, to sue under this Florida statute because they've been harmed by a rating. There's no evidence presented at trial that that was an appropriate interpretation of this law ... with chilling effects on the First Amendment for sure, and also on the ability of any organization to rate and criticize businesses.”

— Leah Binder, President and CEO, Leapfrog Group (Fierce Healthcare)

What’s next

Leapfrog plans to appeal the judge's ruling. The organization will also move forward with its spring 2026 hospital safety grade release, excluding the five Tenet hospitals as well as any others impacted by the imputation methodology. Leapfrog says it will release a new methodology in the fall 2026 ratings that will allow it to grade all hospitals.

The takeaway

This case highlights the ongoing debate over the transparency, fairness, and scientific basis of hospital safety rating systems. It also raises broader questions about the legal rights of businesses to challenge ratings and reviews that they believe unfairly harm their reputations.