Social Worker

Integrity Care Group LLC; Manteca (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Integrity Care Group is seeking a Social Worker to deliver medically related social services within a small, home-like skilled nursing facility setting in California. The role emphasizes timely psychosocial assessments, care planning participation, counseling, discharge planning, and advocacy for resident rights.

The position requires a degree in social work and at least one year of healthcare social services experience, with knowledge of Title 22 regulations and strong documentation skills.

Qualifications

• Minimum one (1) year of experience providing social services in a skilled nursing, subacute, CLHF, hospital, or similar healthcare setting.
• Knowledge of California Title 22 regulations, resident rights, care planning processes, and discharge planning requirements.
• Strong clinical assessment, documentation, and interdisciplinary communication skills.

Responsibilities

• Conduct a comprehensive psychosocial assessment of each resident within five (5) days of admission and document findings in the health record.
• Participate in the interdisciplinary care planning process and develop/update individualized psychosocial care plans.
• Provide counseling, crisis intervention, and supportive services to residents and families.
• Coordinate discharge planning from admission onward, including post-discharge needs assessment and community resource referrals.
• Advocate for and educate residents and families regarding resident rights and care decisions.
• Participate in interdisciplinary team meetings, case conferences, and quality assurance activities.
• Maintain timely, accurate documentation of social service interventions, progress notes, and care plan updates.
• Assist with identification and resolution of psychosocial issues affecting care, including behavioral concerns.
• Maintain knowledge of community resources (HCBA Waiver, Medi-Cal, regional centers, home health, hospice) and facilitate referrals.
• Ensure compliance with CLHF licensing standards related to social services, resident rights, and documentation.

Skills

Clinical assessment

Documentation

Interdisciplinary communication

Education

Degree in Social Work

Job description

The Social Worker is responsible for delivering medically related social services that support the highest practicable physical, mental, and psychosocial well-being of residents in accordance with California Health and Safety Code §1250(i) and §1267.13, and applicable Title 22 California Code of Regulations requirements for skilled nursing facilities (to the extent they apply to CLHFs). This role ensures residents and families receive timely psychosocial assessment, care planning participation, counseling, discharge planning, and advocacy in a small, home-like congregate setting.

Essential Duties and Responsibilities

• Conduct a comprehensive psychosocial assessment of each resident within five (5) days of admission (or sooner as clinically indicated) and document findings in the health record.
• Participate in the interdisciplinary care planning process; develop, implement, and update individualized psychosocial care plans that address emotional, social, family, cultural, and environmental needs.
• Provide counseling, crisis intervention, and supportive services to residents and families to assist with adjustment to illness, disability, loss, and the CLHF environment.
• Coordinate discharge planning from admission onward, including assessment of post-discharge needs, arrangement of community resources, and collaboration with the care team to ensure a safe and orderly transition.
• Advocate for and educate residents and families regarding resident rights under applicable state and federal regulations, including participation in care decisions, grievance processes, and transfer/discharge protections.
• Participate in interdisciplinary team meetings, case conferences, and quality assurance activities.
• Maintain timely, accurate, and confidential documentation of all social service interventions, progress notes, and care plan updates in compliance with Title 22 and facility policies.
• Assist with identification and resolution of psychosocial issues that may affect care, including behavioral concerns, family dynamics, and resource needs.
• Maintain knowledge of community resources (HCBA Waiver, Medi-Cal, regional centers, home health, hospice, etc.) and facilitate appropriate referrals.
• Ensure compliance with all CLHF licensing standards related to social services, resident rights, and documentation during surveys and inspections.

Qualifications

• Degree in Social Work or related human services field with relevant healthcare experience considered..
• Minimum one (1) year of experience providing social services in a skilled nursing, subacute, CLHF, hospital, or similar healthcare setting strongly preferred.
• Knowledge of California Title 22 regulations, resident rights, care planning processes, and discharge planning requirements.
• Strong clinical assessment, documentation, and interdisciplinary communication skills.
• Ability to work effectively in a small (18-bed), home-like environment with medically complex residents.
• Exposure to residents with complex medical conditions, including potential ventilator dependence or terminal illness, consistent with the facility’s licensed CLHF scope of services.

Integrity Care Group is an equal opportunity employer. This position description is intended to describe the general nature and level of work and is not an exhaustive list of all duties. Duties may be adjusted to meet regulatory requirements and resident needs.