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Smart patient rooms are arriving; however, their value has yet to be explored. We interviewed 20 patients in a rehabilitation hospital, which has patient rooms equipped with off-the-shelf smart home technologies, so the entertainment and environment are digitally controllable. This novel implementation supports varying control abilities through touchscreen, voice command, and accessibility controllers. The smart rooms and controls are potentially transformative for patients with reduced motor function, helping them regain lost independence and control of their surroundings. Through semi-structured interviews, we explore how smart home technology deployed in patient rooms: interacts with patients’ needs, presents new challenges, and fits into the hospital context. We identify a range of considerations that inform how hospitals can integrate smart technology into their environment, including technology design considerations and adjustments to how hospital staff supports its use. These results take an important step toward understanding and improving the value of smart patient rooms.