Leapfrog Safety Grades: 372 Hospitals Earn Straight A’s, But 5 Get an F Amid Controversy

Even while facing a heated legal dispute, the Leapfrog Group has released its latest hospital safety ratings. Hundreds of hospitals received top marks, but only five scored an F.

Four states had the highest share of hospitals earning an A: Connecticut, Virginia, South Carolina, and Utah. In those states, more than half of the hospitals that were graded received an A in Leapfrog’s spring edition of its Hospital Safety Grades.

To determine the grades, Leapfrog looked at 22 different measures. These include whether hospitals have enough ICU doctors on staff, how many nursing care hours each patient gets per day, rates of medical errors, infections caught in the hospital, and how well staff clean their hands.

“For a very long time, those of us deeply concerned about patient safety lamented that it never seems to get better. Today we can say that has changed,” Leah Binder, Leapfrog’s president and CEO, told MedPage Today. “Across 17 patient safety metrics we see sustained unmistakable improvement nationally.”

The latest report showed that 372 hospitals didn’t just get an A — they earned a “Straight A.” That means they have kept the highest grade for more than two years in a row.

Only five hospitals received the lowest possible grade, an F. They are: CAMC Teays Valley Hospital in West Virginia; Roseland Community Hospital in Chicago; South Central Regional Medical Center in Laurel, Mississippi; Weirton Medical Center in West Virginia; and WVU Fairmont Medical Center in West Virginia.

Not every U.S. hospital is included in the ratings. But among those that were graded, 917 got an A, 740 got a B, 646 got a C, and 55 got a D.

Leapfrog’s A-through-F grading system for general acute care hospitals started in 2012. Now it faces a major challenge. In March, the group lost a lawsuit filed by five Tenet hospitals in Palm Beach County, Florida. Those hospitals claimed Leapfrog misled the public about how it calculated grades. They also stopped sending data to Leapfrog’s annual survey, which the group uses for many of its metrics.

The hospitals argued that because they refused to take part, Leapfrog gave them lower scores. They said this resulted in “artificially deflated overall grades with no basis in fact and no correlation to a hospital’s actual safety performance.” They claimed Leapfrog’s method of filling in missing data — called “imputation” — was designed to punish hospitals that didn’t participate.

A U.S. District Court Judge for the Southern District of Florida agreed. He called Leapfrog’s method “unfair and deceptive” and said it violated the Florida Deceptive and Unfair Trade Practices Act. He ordered Leapfrog to remove the grades for those five hospitals.

Leapfrog is appealing that decision. But it has also removed scores for another 445 hospitals that did not submit survey data. Those hospitals are now listed as “GNA,” which stands for “grade not assigned.”

Because of this change, the latest report card rated 2,363 hospitals — 16% fewer than the 2,813 general acute care hospitals that were previously scored.

“We wouldn’t change our methodology for just 5 hospitals so we applied the court’s injunction nationally,” Binder said. “We disagree with the ruling, but of course in the meantime we are complying with it.”

In March, Leapfrog released a statement calling the judge’s decision “a threat to patient safety.”

In a motion for reconsideration filed last week, Leapfrog argued that the court’s decision goes against the First Amendment, which protects subjective evaluations. Leapfrog warned that the ruling could affect many other online rating services that rely on weighing different pieces of data.

The motion also said Leapfrog did not misrepresent how it describes its grading method. And even if it had, the motion argued, the hospitals would have had to prove malice.

“Leapfrog respectfully urges the Court to take account of Plaintiffs’ post-judgment efforts to anoint themselves as censors who could use the Court’s order as a template to warp and silence unfavorable reporting by any healthcare or press organization, even beyond Safety Grades,” the motion said.

It added that without a change, “this may become a case study in how Florida’s law of ‘unfair trade practices’ can be deployed to shut down and penalize candid, incisive public reporting.”

Other factors Leapfrog uses in its grading include whether hospitals use computerized systems for doctor orders, barcode scanning for medications, results from patient experience surveys required by CMS, and whether the hospital has leadership structures that support a safety culture. Some data comes from reports hospitals must send to the government, while other data comes from Leapfrog’s own survey.

Source: MedPage Today