Table 3. Common Themes From Reviews of SNFs With High vs Low Rehospitalization Rates.

Theme	Theme defined	Language from word clouds	Rehospitalization rates
			High	Low
Communication	Staff ability to transfer information among facility team, with caregivers, and with external providers	Called; asked; speak; told; phone; doctor; nurse; back; finally	“It takes over 20 minutes or more for someone to attend to a patient when they hit their call button.” (1958)	“ I must say I am impressed with staff...There are people constantly checking on my dad... Between the doctor’s nurse practitioner nursing and therapy staff they got his pain under control. They kept me in the loop. [I] can’t thank [them] enough.” (839)
Environment	Experiences in the physical space and general atmosphere of the facility	Home; life; activities; months; years; living; feel; friends	“Upon arrival I was shown to her room. It had garbage on the floor.” (16)	“The facility itself is very accessible, clean, newer, bright, inviting, and has state-of-the-art equipment for the level of rehab we needed.” (635)
Staff attitudes and behaviors	Responses to staff members affect, display of professionalism, and caring behaviors	Nursing; family; teamwork; great; experience; hard work; caring	“They just like rich people. If you ask question about meds they get upset. So rude.” (1028)	“The staff are caring individuals who truly put patients and their family first. They are a friendly team who work well together and provide great care.” (554)
Management	Issues around billing, customer service, and organizational culture	Insurance; information; money; customer service; office	“Horrible customer service. Called for pricing and questions they are rude and literally will hang up on you. I guess I won't be using them. They lost my money.” (667)	“The management is so friendly, they are like family.” (34)
Care quality	Delivery of safe care, especially performing activities of daily living (ie, patient hygiene), managing pain, and preventing adverse events	Hospital; surgery; doctor; pain; infection; medications; blood	“My dad was becoming worse and had a high temperature 105. I called and spoke with his nurse about my concerns. She said his vital signs were good and he responded to her. I demanded they call an ambulance and transfer him to the hospital…He was unable to speak temp 105 had pneumonia dehydrated and had MRSA.” (1212)	“Great facility very caring people work here physical therapy was great husband like the food bed was comfortable and when he called for help they came quickly. I highly recommend after surgery! My husband had a complete knee replacement and overall care was fabulous!!” (388)

Abbreviation: SNF, skilled nursing facilities.