LGBTQ+ patients face very significant challenges in health care: 56 percent of lesbian, gay, and bisexual people report experiences of serious discrimination, while 70 percent of transgender people report serious discrimination. In response, CMS and The Joint Commission have issued requirements for LGBTQ+ equity and inclusion. The HEI is an annual online survey designed to meet the needs of all health care organizations seeking to provide optimal care to LGBTQ+ patients and to meet CMS and Joint Commission requirements related to this underserved population. The survey rates hospitals and health care 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.