A lawsuit over hospital grades becomes a free speech showdown
THC•Five South Florida hospitals owned by Tenet Healthcare won a lawsuit against nonprofit Leapfrog over its safety-rating methodology. Leapfrog is appealing, arguing its grades are protected by the First Amendment; a judge ordered it to stop grading the hospitals under the current or similar methodology and pay attorney fees that could top $10.5 million.
1. Dispute over ratings
The five hospitals, which did not participate in Leapfrog’s surveys, sued after receiving D and F grades, alleging the grading system was unfair and deceptive. Under a methodology adopted in 2024, Leapfrog assigns the lowest scores in certain categories when nonparticipants have missing data, which tends to lower their overall grades.
2. Appeal raises speech issues
After a five-day trial, U.S. District Judge Donald Middlebrooks ruled that Leapfrog’s approach was an unfair and deceptive business practice. He ordered the nonprofit to stop assigning grades to the five hospitals under the current or similar methodology, make corrective disclosures and pay the hospitals’ attorney fees, which could exceed $10.5 million. Leapfrog argues on appeal that its grades reflect editorial judgments protected by the First Amendment and that the order amounts to an impermissible prior restraint.
3. Broader implications
The hospitals contend Leapfrog misleads consumers about how its grades are calculated and uses low scores to push survey participation. Leapfrog and groups supporting its appeal argue that ratings and reviews are protected expression, while the hospitals say consumer-protection law applies to deceptive statements about the methodology. The 11th U.S. Circuit Court of Appeals will consider which framing applies.
