The latest iteration of The Leapfrog Group’s Hospital Safety Grades has released, this time with additional kudos to repeat high performers and the threat of a lawsuit from disgruntled Tenet Healthcare hospitals in Florida.
The litigation, filed this week by five plaintiff hospitals that received “D” or “F” grades from Leapfrog this spring, alleging that the “deceptive” scoring system is too harsh on facilities that don’t complete the voluntary survey.
Leapfrog has defended its methodology and said it intends to “win in court as we always do.”
The watchdog’s twice-annual grading handed out scores to more than 2,800 hospitals based on patient safety data submitted to the federal government or voluntarily sent to the group through its regular surveys.
Among these, 908 hospitals received the highest “A” grade, with 346 being designated as “Straight A” for having done so across the past five grading periods. Further, 11 hospitals have earned Leapfrog’s highest grade since it began the review more than 13 years ago.
In full, Leapfrog awarded 32% of hospitals an “A” letter grade, 24% a “B,” 35% a “C,” 7% a “D” and less than 1% an “F.”
The proportions are roughly in line with the group’s fall ratings, with very slight increases among “D” and F” hospitals of less half a percentage point.
A representative of the organization also highlighted substantial progress among the hospitals on healthcare-associated infections since the relative high seen in fall 2022. This comes shortly after Leapfrog had highlighted major gains on hand hygiene practices and compliance in a fall report.
State rankings released alongside the new grades outlined Utah as having the largest percentage of “A” hospitals (60.7%), followed by Rhode Island (55.6%) and New Jersey (54.5%). Four states had zero top-scoring hospitals: Wyoming, Vermont, North Dakota and Iowa.
Similar state-by-state rankings were available specific to the 346 “Straight A” hospitals. Here again Utah led, with 29%, as did Connecticut, also with 29%.
“All hospitals should be proud to earn an ‘A,’ but they should not rest on that laurel,” Leah Binder, the group’s president and CEO, said in a release. “Patient safety is a relentless, never-ending quest to put patients first. … Sustaining an A over multiple years reflects a deep-rooted commitment to patient safety.”
The watchdog encourages patients and families to visit its online tools to compare the ratings of their nearby hospitals when choosing where to receive care.
Leapfrog's grading 'riddled with falsehoods,' plaintiff hospitals say
Leapfrog’s release lands the same week as the group was the target of a fresh legal complaint from disgruntled hospitals.
The five plaintiff hospitals—all part of the Palm Beach Health Network, a Tenet Healthcare subsidiary health system—had not seen their scores severely impacted over multiple years of not submitting the voluntary survey but said methodology change last year now has the group “deliberately fail non-participating hospitals.”
The plaintiff hospitals said the change has harmed their reputation with patients and that they had made “repeated efforts” to address their concerns with Leapfrog.
“Leapfrog’s so-called grades are not grounded in credible science or independent analysis—they are riddled with falsehoods, distorted by undisclosed financial incentives, and misused to pressure hospitals and mislead the public,” according to a release from the hospitals. “This is not transparency—it’s a marketing scheme masquerading as public health advocacy.”
Leapfrog disagrees. In correspondence letters between organizations’ legal counsels viewed by Fierce Healthcare, Leapfrog defended its methodology and declined to “suppress” spring ratings as requested by Tenet in an initial Jan. 3 letter, citing the First Amendment. Tenet disagreed, telling Leapfrog that “defamatory statements masquerading as ‘opinions’” are not protected free speech"—a position it formalized in the legal complaint.
Leapfrog, in its first response, told Tenet that the legal threat was “an attempt to shoot the messenger” instead of addressing poor patient safety outcomes outlined in the public data Leapfrog uses in its methodology. Using fall 2024 grades as reference, Leapfrog noted that Tenet hospitals were four times less likely to receive an “A” grade and 12 times more likely to receive an “F” grade than all other U.S. hospitals.
“Most other health systems achieve far greater results in patient safety than Tenet,” the group wrote in its letter. “For instance, HCA consistently outpaces the national average in its percentage of ‘A’ hospitals. Nearly all hospitals in the Advent Health system based in Florida earn ‘As’. Tenet has no shortage of talent among its employees and leaders, and is fully capable of saving more lives and achieving excellence in patient safety.”
Tenet, in a subsequent letter and the filing, pointed to prior criticisms of Leapfrog’s methodology that were published by researchers in peer-reviewed journals. Leapfrog, in response, said those critiques are now outdated in light of year-to-year methodology updates it introduces to better characterize hospitals’ patient safety profiles.
The plaintiff hospitals’ legal representatives sent a final request to Leapfrog on April 17 that they be excluded from the spring 2025 release or face a lawsuit (or, if not, to at least have their inclusion delayed ahead of an impending preliminary injunction motion). Leapfrog’s counsel replied on April 24 that it would not do so.
Palm Beach Health Network’s complaint requests the court enjoin Leapfrog from including its hospitals in the most recent and future Hospital Safety Grades and award at least $75,000 in damages.
Fierce Healthcare has reached out to the hospitals’ parent company, Tenet Healthcare, for an additional statement.
Leapfrog’s Binder, in a statement posted online, criticized the plaintiff hospitals for “using their resources to file frivolous lawsuits” rather than improving patient care.
“These hospitals may wish to withhold their hospitals’ Safety Grades from the community they serve, but Leapfrog intends to fully defend its expert, proven and long-standing methodology to prevent that from happening and publish Grades for all eligible hospitals, including these hospitals,” she said.
Leapfrog is no stranger to lawsuits from graded hospitals. In 2019, for instance, another Florida provider, NCH Healthcare, filed to challenge its “D” rating but dropped the case a year later after it had improved to a “C.”