Homecare Social Worker

Overview

Works under the supervision of the physician in accordance with the plan of care to provide quality therapeutic services for patients, residents, and their families. All services are provided by a qualified MSW. Medical Social Services include assessing emotional factors related to terminal illness, assessing the patient/family psychosocial status, potential for risk of suicide and/or abuse or neglect, assessing environmental resources and obstacles to maintain safety, and assisting the physician and other IDT members in recognizing and understanding the social/mental stress and/or disorder that exacerbates the symptoms related to the terminal illness.

The role participates in the development or revision of the plan of care and provides social services such as short‑term individual counseling, crisis intervention, assistance in providing information and preparing advanced directives, and transfer of responsibilities regarding fiscal/legal and healthcare decisions. The position also assesses need for counseling related to risk assessment for pathological grief and special needs related to cultural diversity including communication, space, role of family members, and special traditions.

Smithfield, Virginia

• Provide therapeutic services for patients, residents, and their families; accurately assess biopsychosocial functioning of assigned patients and residents using effective interviewing skills, behavioral observation, mental health assessment skills, and collateral sources of information, and synthesize information into written documents that inform treatment planning.
• Complete diagnostic summaries as assigned and maximize use of clinical supervision, reporting complex or problematic clinical issues to the Clinical Manager or Program Director.
• Complete individualized, thorough medical record documentation in accordance with facility and departmental policy and maintain timely documentation of case‑management activities.
• Meet productivity measures based on FTE/status and the average number of assigned patients in caseload.
• Deliver quality and clinically sound individual, family, and group therapy interventions based on assessed needs, appropriate for age, stage of development, and level of functioning, and involve the patient/family in the plan of care.
• Provide social services including short‑term individual counseling, crisis intervention, assistance with advance directives, funeral planning, and transfer of responsibilities regarding fiscal, legal, and health‑care decisions; identify and utilize appropriate community resources and assess patient/family ability to access them; evaluate patients for long‑term care when appropriate; communicate psychosocial information when level of care changes; identify patient/family needs at discharge or when level of care changes;
  
  evaluate patient/family response to interventions when referred to community agencies and gauge satisfaction with services.
• Serve as the point of contact for family members, ensuring they are active participants in the treatment process with patient consent, provide education on suicidality, diagnosis, and plan of care as appropriate, address patient/family questions and issues, and assist in assessing financial resources when appropriate.
• Support and benefit patients, residents, department, or facility in productive ways without compromising patient‑care duties during non‑patient‑care time.
• Establish and maintain solid relationships with referral sources, agency personnel, and community providers; build trusting collaborative relationships with the interdisciplinary team to support participant care needs; actively participate in interdisciplinary team meetings; communicate participant and/or caregiver needs, integrate clinical interventions with the plan of care, and evaluate progress on objectives.

• Masters Degree, Social Work (Required)

• Clinical internship in a hospital or residential setting, or two years of clinical experience (Preferred)

• CPR/BLS Certification – American Heart Association/American Red Cross/American Safety and Health Institute (AHA/ARC) within 30 days (Required)
• Licensed Clinical Social Worker (LCSW) – Virginia Department of Health Professions (VDHP) (Preferred)
• Valid driver’s license required; drives personal vehicle for RHS business 25% or more of the time to perform essential functions of the job

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