Healthcare Equality Index Resource Guide

The HEI Resource Guide is a comprehensive instructional and reference accompaniment to the Healthcare Equality Index (HEI) Survey. The HEI Resource Guide covers all of the sections of the HEI survey in great detail, providing explanations of why these policies and practices we ask about are important, example policies, links to outside resources, and more.

Healthcare Equality Index Resource Guide

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The resources provided here are certainly not the only ones available to help guide your organization in LGBTQ+ patient-centered care; however, we hope they can help you get started on implementing best practices in equitable and inclusive care for LGBTQ+ patients. The HEI Resource Guide is also designed to help facilities better understand what is required to receive credit for each question as part of the HEI scoring criteria.

We hope you find the HEI Resource Guide helpful in taking steps to ensure equitable and inclusive treatment for LGBTQ+ patients, families and employees at your facility. If you have any further questions about the HEI, please do not hesitate to contact our team at

Scoring Criteria Overview

The HEI 2024 implements four core objectives which are reflected in its criteria:

  • Ensure foundational protection for patients, visitors and staff in patient and staff policies and provide cultural competency training on LGBTQ+ inclusion
  • Demonstrate progress toward inclusion on LGBTQ+ patient care and support
  • Cultivate an inclusive workforce by providing LGBTQ+ inclusive employee support and benefits
  • Demonstrate public commitment to the LGBTQ+ community

Criteria 1: Non-Discrimination and Staff Training

The questions in this criteria reflect the previous "Core Four" Leader criteria. All questions in this section are scored (5 points each) and must be met in order to attain any tier of recognition.

Criteria 2: Patient Services and Support

The questions in this criteria all relate to best practices in the provision of LGBTQ+ Patient Services and Support. Four subsections comprise this criteria: LGBTQ+ Patient Services and Support; Transgender Services and Support; Medical Decision Making; and Patient Identification and Data Collection. These criteria subsections are divided into two scoring sections for Criteria 2.

Scoring Section One consists of the first three subsections which are scored together for a maximum value of 20 points. Scoring Section Two is the last subsection, Patient Identification and Data Collection which is scored separately for a maximum value of 10 points. These two scores are combined for a maximum total of 30 points for Criteria 2.

Criteria 3: Employee Benefits and Policies

The questions in this criteria all relate to best practices in the policies and benefits that most impact LGBTQ+ employees.

Similar to Criteria 2, there are two scoring sections in Criteria 3. The first scoring section consists of the two subsections of Equal Benefits and Additional Support for LGBTQ+ Employees.

Each subsection in this criteria is scored separately and then combined for a total value of up to 20 points for Criteria 3. The first subsection consists of 15 scored questions and a facility may either receive full or partial credit depending upon the number of initiatives a facility has in place. The second subsection’s score is dependent upon the provision of transgender healthcare benefits for employees at the facility. This practice, alone, is worth 5 points.

Criteria 4: Patient and Community Engagement

The questions in this criteria all relate to how a facility engages with their LGBTQ+ patients and the larger LGBTQ+ community. A maximum of 10 points are available for this section.