Medical Social Worker – Hospice

Position Summary

The Medical Social Worker provides psychosocial support and medical social services to hospice patients and their families in accordance with each patient’s individualized Plan of Care.

This position works collaboratively with the hospice interdisciplinary group (IDG) to assess psychosocial needs, support patients and caregivers throughout the end-of-life journey, connect families with appropriate resources, and promote continuity and coordination of care.

Position Responsibilities

Assessment & Plan of Care

• Complete psychosocial assessments and contribute to the hospice comprehensive assessment and individualized Plan of Care within required time frames.
• Assess the patient’s and family’s emotional, social, financial, environmental, cultural, and psychosocial needs and available resources.
• Identify psychosocial concerns, interventions, goals, and support needs related to the patient’s terminal illness and hospice care.
• Assess the patient and family’s ability to cope with illness, decline, dying, death, and related changes.
• Participate in the development, review, and ongoing update of the patient’s Plan of Care.

• Provide medical social services, counseling, education, advocacy, and psychosocial support consistent with the patient’s needs and Plan of Care.
• Assist patients and families with identifying and accessing appropriate family, community, financial, and supportive resources.
• Assist with discharge and transfer planning when appropriate.
• Evaluate the patient and family’s response to social-work interventions and modify recommendations as needs change.
• When a patient or family declines social-work services, remain available to the interdisciplinary group and reassess or offer support as patient and caregiver needs evolve.

• Participate in interdisciplinary group (IDG) meetings and collaborate with the patient’s Case Manager and other members of the hospice care team.
• Communicate relevant changes in the patient’s or family’s psychosocial, emotional, social, or environmental needs to the interdisciplinary team.
• Serve as a resource to members of the hospice team regarding psychosocial, emotional, family, environmental, and community factors affecting the patient and caregivers.
• Coordinate services and visits with other members of the interdisciplinary team as appropriate.

• Maintain complete, accurate, timely, and relevant clinical documentation in accordance with organizational policy and applicable regulatory requirements.
• Document assessments, interventions, patient and caregiver responses, changes in condition or need, care coordination activities, and other required clinical information.
• Participate in Quality Assessment and Performance Improvement (QAPI) activities as assigned.

• Maintain required professional licensure and qualifications.
• Maintain knowledge of hospice social-work practices and applicable professional standards.
• Participate in continuing education, workshops, conferences, professional organizations, or other development activities as appropriate.

• Current and active Ohio license to practice social work, such as Licensed Social Worker (LSW) or Licensed Independent Social Worker (LISW), as applicable to the individual’s education, experience, and scope of practice.
• Must meet applicable federal hospice personnel qualification requirements for social workers.

Candidates must meet applicable federal and Ohio requirements, including one of the following qualifying educational pathways:

• Master of Social Work (MSW) degree from a school of social work accredited by the Council on Social Work Education (CSWE);
  or
  
• Bachelor’s degree in social work from a…