Social Worker - Oakridge

Pioneer-Health-Care-Management-; Utica (MI); On-site; USD 48,000 - 56,000; Full time

Job summary

Oakridge Manor in Ferndale, MI is seeking a dedicated Social Worker to identify residents' social, emotional, and psychological needs and develop personalized plans to help them reach their full potential during their stay.

You will educate residents and families about post-acute options, coordinate care with the interdisciplinary team, and manage discharge planning, care conferences, and documentation in the EMR.

Qualifications

• Bachelor's degree in social work or related human services field.
• At least 1 year of supervised social work experience in a health care setting.

Responsibilities

• Complete and document Social Work assessments within 3 days of admission.
• Ensure 3877/78 forms are completed and accurate, upon admission and annually.
• Coordinate care with the IDT and conduct Resident Care Conferences.
• Develop and update Care Plans including Psychosocial, Discharge Planning, Behavioral, Cognitive, mood, and related needs.
• Educate residents and families about Advanced Directives and related processes.
• Document all interactions with residents, families, and health care providers in the Medical Record.
• Demonstrate proficiency with EMR for the facility.
• Involve in discharge planning and coordination of DME & Home Care as needed.

Skills

Social work

Discharge planning

Education

Bachelor's degree in social work

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Social Worker - Oakridge

Full Time Oakridge Manor, Ferndale, MI, US

6 days ago Requisition ID: 4069

Title: Social Worker

Reports to: Nursing Home Administrator

Effective Date: 7/1/2017 Review Date: 4/1/2021

Job Summary

Identifying each resident’s social, emotional and psychological needs

Developing and carrying out a plan to develop the resident’s full potential during their stay

Educates patient/family regarding post-acute options and addresses issues of choice

Assists team members with discharge planning activities

Core Responsibilities :

Complete and document Social Work and Psychosocial assessments for all residents within 3 days of their admission or readmission.

Ensure 3877/78 forms are completed and accurate, upon admission and annually.

Ensure all new admissions and readmissions have a scheduled 72 hour Resident Care Conference. Additionally, you will notify the IDT by email of date, time, resident and if family will be attending. This goes for quarterly and annual Resident Care Conferences as well.

Complete MDS sections and the appropriate CAA’s.

Completes, reviews and updates Care Plans including, Psychosocial, Discharge Planning, Behavioral, Cognitive loss, mood, vision, hearing Podiatry, dental. Ensures diagnosis, and medications are accurately captured on the resident’s care plans.

Monitor the behavior log book and follow up on any new or changed behaviors noted.

Monitor high risk residents including but not limited to:

Psychiatric dx. And/or medications

Age 55 or under

Residents with communication barriers

Attend the weekly Medicare Meeting

Attend the monthly QAPI meeting and have all your data prepared to speak on. Remember to separate your lists into short and long-term residents.

Coordinate care with the psych provider including medication management, medication consents, GDRs.

Coordinate all ancillary services, Dental, Ophthalmology, and Audiology the resident may need or request with the input of the DON and/or Administrator.

Educates residents & families related to Advanced Directives, completes the Advance Directive and Code Status form within 48 hours of admission.

Greets Residents, families, etc, introduces self, and identifies purpose for visit

Ensures daily visits and assessments x 3 days for any resident involved event including documentation.

Documents all interactions with residents, families, Health Care Providers etc in the Medical Record.

Demonstrates proficiency with EMR for facility.

Handles problems of adjustment to the facility environment and maintains frequent contact with residents & families.

As needed may be involved in in-service training of aides and staff related to resident rights and Social Services.

Effectively and thoroughly answers patient and family questions

If a hospice referral is indicated, coordinate care with the provider.

Begins discharge planning for residents on admission & ongoing, working with all aspects of the interdisciplinary team to ensure an appropriate/safe resident discharge.

Provide resident/family with written information about the resident rights related to discharge including the appeal process.

Arranges DME & Home Care for residents at time of discharge.

Establishes working relationships with community health, welfare and volunteer groups to promote cooperative assistance in meeting social needs of residents & families.

Demonstrates kind, caring demeanor with resident, family and staff interactions.

Other duties as requested

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Minimum Qualifications

Bachelor's degree in social work – or – a Bachelor's degree in a human services field including but not limited to sociology, special education, rehabilitation counseling, gerontology and psychologyrequired

1 year of supervised social work experience in a health care setting working directly with individuals required