This cross-sectional self-assessment study evaluated organizational health literacy responsiveness in a large public hospital located in Northeastern Brazil using the OHL-Hos tool. The findings highlight strengths in care organization, clear communication, and the promotion of health literacy among patients and families, particularly within clinical sectors. Conversely, weaknesses were identified in stakeholder engagement, staff health literacy training, and community outreach activities. The tool proved to be a practical resource to support quality improvement, reduce informational barriers, and strengthen health literacy and equity in hospital care settings.