The Leapfrog Group must remove its grades dating back to fall 2024 for five Tenet Healthcare Corp. hospitals, a federal judge ruled Friday.

The hospitals sued Leapfrog last year, alleging the organization allegedly pressured facilities to participate in its surveys and pay membership fees for fear of poor safety grades.

Judge Donald Middlebrooks ruled Leapfrog’s grading process for non-participating hospitals was “unfair and deceptive.” He ordered Leapfrog to stop assigning safety grades to the five hospitals under the current scoring framework if they choose not to submit their data or otherwise participate in the program in the future.

Related: Tenet hospitals sue Leapfrog Group over ‘pay-to-play’ grades

He also ordered Leapfrog to send out corrective disclosures to all entities that paid to license safety grade reports from fall 2024, spring 2025 and fall 2025, stating that the reports were found to be unfair and deceptive.

The five Tenet hospitals, all in Florida, are Good Samaritan Medical Center and St. Mary’s Medical Center, both based in West Palm Beach; Delray Beach-based Delray Medical Center; Palm Beach Gardens Medical Center; and West Boca Medical Center in Boca Raton.

The hospitals said in the complaint they decided to stop participating in Leapfrog’s surveys and allegedly received worse grades afterward. Two of the hospitals received a “D,” while the other three received a “F” in Leapfrog’s spring survey released April 30, the day the suit was filed. In fall 2025, the most recent round of safety grades, three of the hospitals received a “D,” one received an “F” and one was not graded.

Leapfrog has denied all allegations.

The hospitals did not seek monetary damages. They initially sought at least $75,000, but amended their complaint in August 2025 to only request Leapfrog remove past grades and stop grading these facilities in the future.

Leapfrog President and CEO Leah Binder said in a statement Sunday the organization plans to appeal the decision immediately.

“We vehemently disagree with this decision, as we believe it threatens the First Amendment rights of every American,” Binder said. “While we intend to appeal, we will comply with the injunction in the meantime. The spring 2026 update of the Leapfrog Hospital Safety Grade will continue as planned, with some modifications based on the injunction which will be shared in the coming days.”

Dallas-based Tenet sent Leapfrog a cease-and-desist letter in January 2024 before its hospitals filed the lawsuit. In the letter, which Leapfrog shared with Modern Healthcare, the system demanded that Leapfrog remove all Tenet hospitals from its lists. Leapfrog declined to remove the ratings at the time.

Leapfrog sent its own cease-and-desist letter in May demanding the hospitals stop spreading what it characterized as “false statements.”