The "health literacy environment" of a healthcare facility represents the expectations, preferences, and skills of those providing health information and services. Some of these demands are in the form of physical aspects of the hospital or health center, such as signs and postings. At the same time, access to and navigation of health services involves the use of a broader range of print materials such as applications, rights and responsibilities postings, payment calculations, medical history forms, directives, information booklets, and consent forms. In addition, the oral exchange in discussions with providers is of critical importance. Healthcare workers often use the language of their discipline, and words may get in the way of clear communication. This guide and the review tools found within it offer an approach for analyzing literacy-related barriers to healthcare access and navigation. The authors designed this guide to assist chief executive officers, presidents, program directors, administrators, and healthcare workers at hospitals or health centers to consider the health literacy environment of their healthcare facilities and to analyze ways to reduce demands, to better serve their patients and staff and ultimately to increase revenue. Appendices include: (1) Partners for Action Examples; and (2) Needs Assessment Tools. (Contains 4 footnotes and 14 resources.)