Conclusions: Despite very different organizational structures and processes, we found similar patient populations, risk factors, and outcomes in the two hospitals. The linkages in these different health care facilities between readmissions and health system barriers to safe and smooth transitional care confirm findings in other studies. Patient and organizational factors each contributed to unscheduled readmissions. High-risk patient targeting, improved communications (including a greater emphasis on language barriers and cultural differences), and better coordination of care and followup could potentially prevent some readmissions when transitioning patients from the hospital to the home.