Article
The decision
On March 6, Judge Donald Middlebrooks of the US District Court for the Southern District of Florida granted an injunction sought by Palm Beach Health Network, a group of five Tenet-owned hospitals: Good Samaritan, St. Mary’s, Delray, Palm Beach Gardens and West Boca medical centers. The hospitals sued under Florida’s Deceptive and Unfair Trade Practices Act after they stopped taking part in Leapfrog’s annual survey and then received low grades.
The court focused on Leapfrog’s practice, since 2024, of assigning the lowest score on four measures when a hospital did not submit survey data: computerized physician order entry, bar-code medication administration, ICU physician staffing and hand hygiene monitoring. Together those measures can account for about a third of a grade. The judge found the approach could mislead the public. Leapfrog must withdraw the five hospitals’ grades for fall 2024, spring 2025 and fall 2025, and may not grade them under the current framework if they decline to participate.
Leapfrog’s response
Leapfrog said it strongly disagrees, called the decision a threat to patient safety and plans to appeal on First Amendment grounds. It will comply while the appeal proceeds, and its spring 2026 grades will move forward with changes reflecting the injunction. The hospitals did not seek damages.
What it means for other hospitals
The order applies only to the five plaintiffs, and an appeal is coming. Still, it is a notable legal check on how a major rating organization treats hospitals that do not participate, and some systems may revisit their own participation decisions.
Quality and communications leaders should avoid overreading it. Employers and payers still use these grades, and leaving a survey does not remove a hospital from public scrutiny. A more durable approach:
- Identify which ratings matter most to your patients, employers and payers, and why.
- Understand each rater’s methodology, including how missing data is scored.
- Make participation decisions deliberately, with input from the board quality committee, rather than by default.
- Keep investing in the underlying practices, such as medication safety technology and ICU staffing, regardless of how any rater scores them.
Archive entry for Mar 15, 2026, added Nov. 11, 2026.
Sources
- Statement from Leapfrog President and CEO Leah Binder on the Tenet Healthcare Lawsuit Decision (The Leapfrog Group, Mar 8, 2026)
- U.S. judge rules Leapfrog’s safety ratings were unfair to nonparticipating hospitals (WUSF, Mar 9, 2026)
- Florida judge orders Leapfrog to remove safety grades for 5 Palm Beach County hospitals (Palm Beach Health Network, Mar 13, 2026)