When American hospitals were ranked based on their treatment of gay and lesbian patients about 88 American hospitals who participated in a survey received top marks under a new rating system created by two national gay-rights organizations.

Called the Healthcare Equality Index, the ratings were designed by the Human Rights Campaign and the Gay and Lesbian Medical Association in the hopes that hospital standards will include more compassionate treatment of gay and lesbian patients.

Policies addressed in the ratings include patient nondiscrimination, visitation and decision-making rights for partners, staff diversity training and nondiscriminatory employment practices.

The hospitals participated voluntarily, and the groups behind the report said there will be no effort to rate hospitals that don't want to respond. Instead, they hope many hospitals will strive for high ratings as the survey recurs annually.

"This year's survey results show that many hospitals are making strides in the right direction," said Joe Solmonese, president of the Human Rights Campaign. "However, through real-life stories, we learn that GLBT individuals face discrimination in healthcare settings every day.  Some are denied access to their partners or children during an emergency. Others fall victim to their healthcare provider's assumption of heterosexuality and lack of knowledge of GLBT heath needs," Solmonese said.

"In short, a great deal of work remains to be done."

In one example cited by the HRC to the Associated Press, attorney Kenneth Johnson described his struggle to verify his relationship with his partner, James Massey, in 2006 when Massey was rushed unconscious to Howard University Hospital in Washington, D.C.

Johnson said he had to travel back to his home in Virginia to fetch legal documents before the hospital allowed him to join in medical decision-making for Massey, who had suffered a cerebral hemorrhage and died the next day. The two men had registered as domestic partners in California and had an adopted son.

The index is modeled after the HRC's Corporate Equality Index, which rates corporations on policies for gay and lesbian workers.

Some responses to the new survey came from hospital networks. Kaiser Permanente, answering on behalf of 31 hospitals in California and Hawaii, said all met the survey's 10 criteria. They were among 45 hospitals in all with top marks.

University Hospitals of Cleveland, representing 10 Ohio hospitals, said they fully met only two criteria -- domestic partner benefits for employees and a patient nondiscrimination policy that includes sexual orientation.

The HRC and the medical association said their goal is to highlight hospitals with high rankings and induce others to abandon inequitable practices.