Social Services - Long Term Care

Summary:

In accordance with the mission and values of The Village of St. Edward, the Social Worker is responsible for providing social services to families/residents in Nursing Care. They act as a bridge between residents, families, and the interdisciplinary care team, ensuring that care is person-centered and compliant with state and federal regulations.

Onsite position

• Provides Social Services to Families/Residents
• Coordinates discharge planning for residents moved to another level of care at The Village of St. Edward or when transferred to an outside institution/setting.
• Assures completion and documentation of Social Services task such as progress notes, social histories, psychosocial assessment, trauma informed care, discharge plan / assessment (BIMS; Brief Interview for Mental Status) ( PHQ-9 Depression Rating Scale)(Resident’s Rights), and assures timely placement of these items in Resident’s charts.
• Assists in care planning in coordination with MDS nurse and completes appropriate sections of the MDS. C-D-E-Q.
• Also provides NOMNC (discharge planning) assists with insurance updates, appeals and submissions.
• Submit insurance updates
• Maintains quarterly documentation including but not limited to progress notes, discharge plans, room changes prior to discharge in accordance with state regulations.
• Coordinates and participates in plan of care meetings
• Provides direction to residents/families with problems/concerns
• Track PASSR and LOC.
• Informs residents and families of their rights and responsibilities. Educates staff about resident rights and facility implementation of those rights acting as the resident’s advocate.
• Helps families/residents with POA documents, living will, Medicaid applications, etc.
• Attends Resident Information Meetings and provides resident’s rights at these meetings.
• Provides educational information to the Caregivers’ Support Group for family members
• Develops and implements ongoing resident right in-service programs and Resident Information Meeting (RIM).
• As a member of an interdisciplinary team, assesses each resident’s potential for discharge. Plans for the resident’s discharge and post discharge with the resident’s family and interdisciplinary team. Assists resident and family in the implementation of the discharge plan and communicates discharge plan to all parties. Follow up with the family within 2-4 weeks after discharge.
• Meets with the psychologist weekly.
• Assists with medical records and ancillary service coordination.
• Performs other duties as assigned.
• Supports the philosophy of person centered care (PCC) by actively participating in the person centered care process. Fosters development and enhancement of person centered care practices.

• High School diploma or equivalent with experience working in social services in long term care
• Graduate of an accredited college for social work or gerontology preferred
• Current license to practice Social Work in the State of Ohio (LSW) preferred.
• At least 1-2 years of experience working with older adults in Social Service capacity
• Availability to work on weekends, evenings, and holidays for operational needs
• Possess the necessary dexterity to operate office equipment, calculators, computers, etc.
• Possess the ability to bend, stoop and reach at different angles.
• Walks, stands and sits intermittently during the day.
• Must be detailed oriented and precise with documentation.
• Strong organizational skills, communication and problem-solving skills.
• Ability to balance multiple priorities and meet deadlines

• A kind and welcoming work environment
• Medical/Vision/Dental…