Leah Binder is the President and CEO of The Leapfrog Group.

The Leapfrog Group is well known to many of our readers, but can you explain the difference between the Leapfrog Hospital and Ambulatory Surgery Center (ASC) Surveys and the Leapfrog Hospital Safety Grade?

We have two voluntary surveys: one for hospitals and one for ambulatory surgery centers (ASCs). Hospitals and ASCs that want to share information with the public about their safety and quality can do so through these surveys. After they submit the surveys, we score them on whether they meet Leapfrog’s high standards for quality and patient safety — and we publicly report the results. Safety and quality are critically important to purchasers and employers, which is why hospitals representing about 80% of inpatient beds nationwide voluntarily participate in the Leapfrog Hospital Survey.

We also produce the Hospital Safety Grade, which applies only to general hospitals with inpatient beds. The Safety Grade evaluates how well hospitals protect patients from preventable harm, such as medication errors, injuries, and infections. It includes 32 measures. Most of the results used to calculate the score come from CMS.

How does Leapfrog determine which measures to include in the Survey and the Grade?

We rely on an extensive research process and multiple expert panels that include faculty from Johns Hopkins Medicine and other leaders in patient safety and measurement science. For example, we have one panel focused specifically on ICU care and another on medication safety, which are among the most common and serious hospital safety issues.

The measures are reviewed annually to ensure they reflect the latest evidence. We also conduct an open public comment period and frequently hear from hospitals and ASCs as well as purchasers and patient advocates during that process. It’s a rigorous process. That’s why Leapfrog was founded — to bring expertise and accountability to measuring patient safety. Employers and purchasers want this information.

The U.S. District Court for the Southern District of Florida recently ruled against Leapfrog in a lawsuit brought by five Tenet Health hospitals in Florida. Is Leapfrog appealing?

Yes, we plan to file a notice of appeal. We believe the decision poses a serious threat to patient safety. The Judge, in this case, focused on a nuance in Leapfrog’s methodology — one that testimony showed would likely not have meaningfully changed the grades of any of the hospitals that filed suit. In our view, the ruling overlooked the broader body of evidence in our methodology and in other ratings systems, including CMS data.

Do you see implications of this decision for free speech or transparency in hospital performance and patient safety data?

Leapfrog has long been a strong advocate for transparency in health care, and the data show that transparency has helped drive real improvements in patient safety over the past decade.

This decision threatens not only Leapfrog but also the employers and purchasers who rely on this information to evaluate hospital safety. Other ratings — including Medicare Compare and Mayo Clinic’s HealthLocator — also give these hospitals low ratings on safety and quality.

Leapfrog is not targeting hospitals. Our goal is for every hospital to be safe. Consumers deserve to know what we know about the performance of hospitals, because so much is at stake for patients. We often see hospitals use the Leapfrog Survey and their ratings to improve their systems and address safety problems. Those are real success stories.

For now, what changes, if any, will be made to the Safety Grades?

We continuously change the safety grade and always look to improve, just as we ask health systems to improve for better patient safety. For now, we have decided to not grade hospitals affected by the specific methodological issue at the center of the case — that affects roughly 17% of eligible hospitals, but none in New Jersey, because all eligible New Jersey hospital complete the Survey, demonstrating their commitment to patient safety.

For the Fall 2026 Hospital Safety Grades, we plan to have a new methodology. After our team develops and tests the new methodology and experts review it, we will publish it for public comment. Updated grading will launch once we have reviewed the public comments and finalized the methodology.