Social Worker - LCSW

Social Worker

The Social Worker provides services to customers and their families/significant others to help them adjust to illness, injury, or hospitalization. The Social Worker assists the health team in understanding the significance of social, economic, emotional, and family factors in relation to the customer's illness, treatment, recovery, or dying processes. They are responsible for facilitating timely, efficient, and appropriate discharge of customers and coordination with the next level of care, including the transmission of the appropriate plan of care.

The Social Worker identifies needed community services and coordinates appropriate services for customers in need.

Discharge Planning:
The Social Worker participates in and implements discharge planning services for customers. They screen and coordinate new nursing home, board care, assisted living facilities, group homes, and hospice facility referrals. The Social Worker validates discharge criteria for customers and families. They follow up with customers, families, and/or facilities as indicated to ensure appropriate disposition and follow-up. The Social Worker works with socially complex customers to identify barriers to discharge.

Assessment and Evaluations:
The Social Worker assesses customers' and families' risk factors through evaluation of prior functioning levels, appropriateness, and adequacy of support systems, as well as reactions to illness and ability to cope. They provide intervention in child abuse, neglect, domestic violence, guardianship (temporary/permanent), foster care, adoption, mental health placement, and adult/elderly abuse. The Social Worker intervenes with customers and families regarding emotional, social, and financial consequences of illness and/or disability.

They access and mobilize family/community resources to meet identified needs. The Social Worker serves as a resource person and provides support and resource information related to palliative care treatment decisions and end-of-life issues.