Objective: Patient-centered care prioritizes individual values, beliefs, and needs. Neglecting aspects of patients’ needs often exacerbates existing disparities. Patients want their spiritual needs addressed and discussed with the healthcare team, but providers feel unprepared to do so. While most patients want chaplaincy care, very few receive it, and little is known about the factors that contribute to its use. Thus, we aim to identify what population characteristics are associated with the utilization of chaplaincy services. Data Sources: Electronic medical record (EMR) data matched with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data for hospitalizations from March 2012 to July 2017. Design: With a retrospective, cross-sectional analysis, hospitalizations for one midwestern acute care hospital, were examined for use of spiritual care services. The dependent variable examined was the amount of chaplaincy care received. The study used variables categorized as predisposing (age, sex, race, ethnicity, language, religious affiliation), enabling (education), and need (self-reported health, self-reported mental health, primary diagnosis, length of stay). Analysis controlled for emergency department admission and date of hospitalization. Data Collection: For each hospitalization, data from the EMR and HCAHPS data were merged; analysis retained the first hospitalization for each individual. Results: Bivariate analyses identified associations between the receipt of chaplaincy care, predisposing variables, and need variables. Bivariate analyses also yielded associations between the amount of chaplaincy care and the same variables. Multivariate analysis utilized a hurdle model that identified the consistent association between need variables and receipt/use of chaplaincy care. Conclusions: Regardless of predisposing or enabling characteristics, those with the most acute health needs were more likely to receive chaplaincy care and received more total care. Patient-centered models focused on whole person care may need to evaluate strategic integration of spiritual care and screening for spiritual needs beyond acute care responses.