Medical social work long-term care referrals for people with HIV infection

Hospital social workers were surveyed to identify referral efforts and outcomes for clients with human immunodeficiency virus (HIV) infection who required long-term placement. Over a three-month period, none of the 42 identified clients was admitted to a nursing home. In two-thirds of the cases, social workers contacted only one facility, and in about one-sixth of the cases, workers reported no placement attempts. Clients remained in the hospital a median overstay of eight days beyond acute care needs, representing 205 aggregate days that could have been spent in less intensive settings. Workers made few placement attempts because of beliefs that they would be unsuccessful or that nursing homes would not accept admissions. Increased communication and education both for referring workers and for long-term care facilities may improve the referral process, reduce costs, and decrease emotional distress for people infected with HIV.