Overview
Social Worker, Scranton Rehab Hospital Transitional Unit (Call In)
GENERAL SUMMARY: Under the direction of the Director of Social Services, the Social Worker aids residents and their families with personal and environmental difficulties which predispose illness or interfere with obtaining maximum benefits from medical care. The Social Worker must provide care appropriate to the age of the residents served (adult through geriatric) and apply knowledge of growth and development, assess resident status, interpret information needed for age-specific needs, and follow Social Service Department policies and procedures.
Qualifications
- Bachelor’s degree in Social Work or related field required.
- Master’s degree in Social Work or related field preferred.
- Minimum of two (2) years of experience in a Social Work Department health care setting required.
Responsibilities and Duties
- Perform the duties of Resident Advocate: respond to resident/family questions and concerns; investigate and follow up on complaints (roommate incompatibility, missing personal items), and document all complaints to determine satisfaction.
- Interview residents and/or family members in allegations of abuse, neglect, or misappropriation of property; ensure accurate documentation for Department of Health reporting requirements.
- Plan and implement room changes to accommodate resident requests, movement to appropriate care units, admissions bed management, and infection control; communicate changes to residents and roommates and document them.
- Facilitate an interdisciplinary approach to bed management and discharge planning; coordinate room changes and communicate with residents, units, and admissions.
- Facilitate acquisition of services (such as Home Health or Outpatient Therapy referrals) and durable medical equipment referrals.
- Communicate changes in financial coverage relative to Medicare/Commercial Insurance to residents and families; facilitate decision-making on new payer sources.
- Perform Social Work Admissions Assessment on each new resident; identify current status, discharge plans, and initiate care plan; maintain case records and chart progress notes as required by Medicare schedules; participate with the interdisciplinary team to resolve resident issues; conduct individual or group conferences as needed.
- Complete assigned Minimum Data Set sections of the resident assessment instrument and ensure timely chart documentation related to care plans.
- Develop Social Work portion of multi-disciplinary care plans and update for mood, behavior, and psychosocial well-being; attend and coordinate care plan meetings with residents and families.
- Provide supportive counseling to residents who refuse care, discharge AMA, or need alternatives; educate on risks and benefits of care decisions.
- Coordinate resident discharge from the facility; communicate with external community agencies to facilitate discharges to home and ensure care needs are met; organize discharge planning meetings.
- Review Code status and Forms of Treatment as requested; notify appropriate family members per policy.
- Participate in educational programs; provide opportunities for residents to safekeep valuables; notify changes in guardianship or power of attorney to relevant disciplines; handle petty cash disbursements as needed; obtain signatures to authorize release of information.