Patients who visit the emergency department (ED) with high frequency are typically categorized as super users, high utilizers, or super-high utilizers (SHUs) based on the relative frequency of hospital care they require, compared with other ED patients (Chambers et al., 2013; Rinehart et al., 2018). Common characteristics of patients with frequent utilization of emergency services are well described in the literature, including high chronic disease burden, substance abuse, and psychiatric disorders (LaCalle & Rabin, 2010; Sandoval et al., 2008; Szekendi et al., 2015). There has been relatively less focus on the characteristics of high utilizers who are frequently admitted to inpatient services following their ED encounters (Boonyasai et al., 2012; Raven et al., 2011). Healthcare spending attributed to the highest utilizers of the ED, categorized as SHUs, is disproportionately high (Bergenstal et al., 2020; Jiang et al., 2006; Moschetti et al., 2018). In healthcare systems constrained by limited inpatient hospital capacity, SHUs compound important patient safety issues, including ED overcrowding. Further understanding SHU characteristics and exploring patient-centered solutions to this population is critical to the contemporary ED care model.