HEI Frequently Asked Questions

The annual Healthcare Equality Index (HEI) is used by inpatient and outpatient healthcare organizations nationwide to strengthen the care they give LGBTQ patients and reach out to this long overlooked group. To view or participate in the HEI, which is free of charge, just register your healthcare organization. And if your questions aren’t answered below, don’t hesitate to contact HEI staff at

What is the HEI?

The HEI is an annual online survey. Created in 2007, the HEI has been designed to meet the needs of all healthcare organizations seeking to provide optimal care to LGBTQ patients and to meet CMS and Joint Commission requirements related to this underserved population.

The HEI scoring criteria rates hospitals and healthcare facilities on policies and best practices in LGBTQ patient centered care in four key areas: Non-discrimination and staff training; Patient services and support; Employee benefits and policies; and Patient and community engagement.

What kinds of organizations can participate?

The HEI is open to all healthcare organizations in the U.S. with 100 or more employees, whether inpatient or outpatient, network or individual facility. Inpatient facilities are particularly encouraged to participate, and constitute the majority of participants.

Why should our organization participate?

LGBTQ patients face very significant challenges in healthcare: 56% of lesbian, gay, and bisexual people report experiences of serious discrimination in healthcare, while 70% of transgender people report serious discrimination. In response, CMS and The Joint Commission have issued requirements for LGBTQ equity and inclusion, and expert recommendations have now emerged for LGBTQ patient-centered care.

The HEI enables healthcare organizations to assess their own policies and practices vis-à-vis these requirements and recommendations, and equips them with the training and resources they need to remedy gaps. It also enables organizations to receive public recognition for their commitment to equity and inclusion.

Hundreds of healthcare organizations nationwide have participated in the HEI to:

  • Increase patient safety and satisfaction
  • Comply with CMS and Joint Commission requirements
  • Minimize risk and maximize quality
  • Enhance their reputation for equity and inclusion

And HEI participants enjoy these unique benefits:

  • Access to free, expert online training for staff at all levels
  • Customized analysis of potential gaps, with resources for addressing them
  • Public recognition for their commitment to equity and inclusion
  • Tools for outreach to LGBTQ community members
What’s involved in participating?

As an online survey, participation in the HEI requires a login. If your organization does not already have a login, you can register to receive one and view the HEI survey with no obligation. The HEI can be completed by any number of people within an organization, as the HEI login can be shared, but each organization is asked to designate an “official submitter” to review and submit the HEI.

Organizations answer a series of questions about LGBTQ policies and best practices and are required to upload supporting documentation to validate many of their responses. Participating organizations will receive a summary of their score after the HEI staff has reviewed their submission and will have an opportunity to provide additional information or supporting documentation to address any deficiencies.

Can we see the HEI?

The HEI 2018 report describes the HEI's questions and methodology. The full online survey can be viewed by any organization that registers for an HEI login, with no obligation to participate — click here to see a sample survey.

Is there a fee?

The HEI, including the extensive training offered to participating organizations, is offered free of charge, as an educational program of the HRC Foundation.

What’s the schedule and deadline?

The HEI 2019 survey session will open in Summer 2018 with a survey deadline of September 30, 2018. The HEI 2019 report will be released in March of 2019.

How can we access free HEI training?

All organizations participating in the HEI may register staff for acclaimed, expert online training— in fact, training is required to be awarded HEI Leader status.

What does it mean to be an HEI Leader? When will we know if we are a Leader?

Survey participants that meet the new HEI Scoring Criteria are designated as a Leader in LGBTQ Healthcare Equality. The Leader designation signals to LGBTQ patients and allies that the healthcare facility has meet the foundational elements of LGBTQ patient-centered care.  Prior to the release of the HEI report, Leaders receive the coveted HEI Leader logo for their use, as well as extensive resources for publicizing their achievement and conducting outreach to LGBTQ community members.

HEI staff will notify all survey participants whether or not they have received Leader status once the review of that facility’s survey is complete.

Do organizations participate in the HEI every year?

Yes. The HEI is revised annually to incorporate new issues and resources related to LGBTQ patient-centered care, and Leader status is determined each year by an organization’s responses to the HEI in that year.