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About the Long-Term Care Equality Index
The Long-Term Care Equality Index (LEI) is the first national benchmarking tool for LGBTQ+ inclusion in senior housing and long-term care communities. With free resources, technical assistance and a biennial survey, the LEI helps communities implement, strengthen, and innovate their LGBTQ+ inclusion efforts with residents, visitors, and staff. The LEI report formally recognizes communities leading in LGBTQ+ inclusion.
The LEI 2025 Survey is now open.
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Make LGBTQ Elders Feel Welcome and Cared For
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LGBTQ Elders Deserve Respectful Care
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HRC Foundation & SAGE's Long-term Care Equality Index (LEI) - Jan and Norma at Edenwald
The LEI Survey Criteria
The LEI promotes LGBTQ+ inclusive policies and practices in residential long-term care and senior housing. The LEI criteria consist of emerging best practices known to improve the experiences of LGBTQ+ older adults, visitors, and staff.
The LEI has four core objectives which are reflected in its survey criteria:
- Ensure foundational non-discrimination protections for residents, visitors, and staff and provide training in LGBTQ+ Resident Centered Care
- Demonstrate progress towards inclusion of LGBTQ+ resident services and support
- Foster an inclusive workplace by providing LGBTQ+ inclusive employee policies and benefits
- Demonstrate engagement with and a public commitment to the LGBTQ+ community
Tiers of Recognition
The LEI recognizes participating long-term care and senior housing communities. Participating communities that have met all of Criteria 1's foundational non-discrimination policies and training can achieve one of three Tiers of Recognition. See below for a description and requirements for each tier.
At this tier, communities are beginning their journey and have a solid foundation of key policies that are codified and communicated. To achieve this tier, communities must have all Criteria 1 practices in place. These practices include an LGBTQ+ inclusive resident non-discrimination policy, equal visitation policy, employee non-discrimination policy, and completion of the executive briefing.
At this tier, in addition to meeting the requirements for the Equality Builder tier, High Performer communities have adopted a minimum of practices in the areas of Resident Services and Supports, Employee Benefits and Policies, and Resident and Community Engagement. To achieve this tier, communities must reach a minimum number of best practices (see below) in Criteria 2, 3, and 4.
At this tier, in addition to meeting the requirements for the prior two tiers, Equality Leader communities have integrated the majority of practices in the areas of Resident Services and Supports, Employee Benefits and Policies, and Resident and Community Engagements. To achieve this tier, communities must reach a set number of best practices (see below) in Criteria 2, 3, and 4, including a transgender-inclusive insurance plan.
Participate in the LEI
The LEI encourages the following housing providers to participate:
- Skilled Nursing Communities
- Memory Care Communities
- Assisted Living Communities
- Independent Living Communities
- Life Plan or Continuing Care Retirement Communities
- Affordable Senior Housing Communities
- Free-Standing Hospice Communities
Executive staff can sign the Commitment to Caring Pledge to get started
The Long-Term Care Equality Index is a collaborative project between The Human Rights Campaign Foundation, the educational arm of the nation’s largest LGBTQ+ civil rights organization, and SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ+ older adults.