The Leapfrog Group, a nonprofit that evaluates nearly 3,000 hospitals nationwide for its quality and safety, is facing intense scrutiny following a March 6 court ruling that labeled its methodology “deceptive” for penalizing non-participating hospitals.
Leapfrog publishes hospital safety report cards twice a year, grading hospitals from A to F based on how well they prevent infections, injuries and medical errors. A federal judge ruled the group violated Florida’s consumer protection law by unfairly penalizing hospitals that didn’t take its surveys.
While the ruling has raised questions about the ratings system, the grades continue to influence how hospitals are evaluated nationwide—including in Los Gatos.
In one standout local result this year, El Camino Hospital Los Gatos received a “B” in Leapfrog’s Fall 2025 report, after six consecutive “A” grades.
On March 8, Leapfrog President and CEO Leah Binder fired back against the injunction by Judge Donald M. Middlebrooks (calling it a “threat to patient safety” across the US) related to five Florida hospitals operated by Tenet Healthcare.
“We vehemently disagree with this decision, as we believe it threatens the First Amendment rights of every American,” Binder wrote. “We will appeal it immediately.”
In the meantime, the company has made some adjustments as it works on its Spring 2026 reports.
Leapfrog calculates placements using 22 safety indicators, made up of 12 outcome and 10 process measures (which each account for 50% of the composite score).
Process measures evaluate whether hospitals have systems that prevent errors before they occur, such as in computerized entries by doctors and medication administration. The El Camino’s Los Gatos location performed strongly here, maintaining perfect scores of 100 across several measures over multiple reporting cycles.
Outcome measures, on the other hand, track complications or adverse events that occur during hospital care. These drive most grade changes, as they tend to fluctuate more.
El Camino Health LG performed worse than in the prior cycle with three outcome measures: foreign object retained after surgery, surgical site infections after colon surgery and C. difficile infection rates.
(Foreign object retained after surgery measures how often a surgical item, such as a sponge or needle, is accidentally left inside a patient’s body after surgery. Surgical site infections after colon surgery track infections that develop in surgical wounds after colon operations, and C. diff infection rates measure infections caused by C. diff, a bacterium that causes severe intestinal illness.)
Both the foreign object retained and C. diff categories were found to be worse than the national average.
All three of these measures, however, were taken from data measured in past years. Specifically, foreign objects retained used data taken between July 2022 and June 2024, while site infections and C. diff infections used data collected in 2024.
“It’s important to note that the change in rating does not reflect a decline in the quality of care our patients receive,” Christopher Brown, director of strategic communications at El Camino Health, wrote in a statement to the Los Gatan. “It is largely the result of adjustments in Leapfrog’s scoring methodology and the timing of data cycles used in the Fall 2025 report. Some of the measures incorporated into this cycle rely on older data and do not represent the significant improvements and investments we have made over the past year.”
Alexandra Campione, program manager for Leapfrog’s Safety Grade Program, wrote in an email to the Los Gatan that a more lengthy reporting period is used to “improve the reliability of the results.”
“When the reporting period is longer, we can see how the hospital performed over time, minimizing the chance that the grade suddenly drops due to a single, possibly uncharacteristic, event,” Campione said.
What’s known as the “PSI-90”—a patient safety indicator and composite measure of multiple hospital complications—also appears to have played a big role in El Camino’s overall grade drop in Los Gatos. As the largest factor of all indicators (it’s weighted at 14.9%), the PSI-90 worsened from 0.79 to 0.87 in Fall 2025 reporting. However, the hospital still scored better than the national mean (which is 1).
Since Leapfrog grades are calculated using dozens of metrics, changes across multiple measures can affect a hospital’s overall grade in a complex manner.
“A single-cycle drop can result from changes in any of these areas, so it’s best not to generalize,” said Campione, when asked about the factors that might commonly drive movements up or down the rankings.
For the Fall 2025 cycle, about 160 “A” hospitals moved down to a “B” grade, which was then offset by a similar number of “B” hospitals moving to an “A” grade, according to Campione. About 80% of “A” hospitals keep their “A” grade per cycle, while 26-32% of hospitals move a single letter grade, she added.
“Preventable medical errors in hospitals harm one in four hospital inpatients and cause as many as 250,000 deaths each year,” Campione said. “The Leapfrog Hospital Safety Grade is the only hospital ratings program focused exclusively on preventing medical errors and patient harm. Just as consumers navigate differing opinions when shopping for products, they should do the same when choosing hospitals.”
