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Major Duties and Responsibilities 

The Social Worker will assist in overseeing the development, implementation, supervision and ongoing evaluation of the Social Services Department designed to meet and assist residents in attaining or maintaining their highest practicable well-being.  This includes identifying the need for medically-related social services and ensuring that these services are provided in accordance with State and Federal regulations.   

The Social Worker will complete the social services component of the comprehensive assessment for assigned residents.  The Social Worker will also contribute to and/or direct/ delegate contribution of social services goals and approaches to the comprehensive care plan.  These goals and interventions will be individualized to match the skills, abilities, and interests/preferences of each resident in compliance with Federal and State regulations, to include identifying and promoting individualized, non-pharmacological approaches to care that meet the mental and psychosocial needs of each resident.  

The Social Worker will encourage residents/responsible parties to participate in the development of their care plan, and invite them to care plan meetings accordingly.  

The Social Worker will assist with completion of preadmission services for inbound residents, to include participation in interdisciplinary evaluation of residents needs for institutional care and completion of the PASARR Level 1.  

The Social Worker will facilitate residents’ safe transition back into the community through interdisciplinary discharge planning and arrangement of community based services and follow-up care.  The Social Worker will also assist residents and their representatives in locating and accessing financial, legal, and other community resources. 

The Social Worker will interpret and report the social, psychological, and emotional needs of the resident/responsible party to the medical staff, attending physician, and other resident care team members. 

The Social Worker will accurately and completely document social service actions and interactions in each resident’s medical record, and ensure that legal, ethical, and professional standards of social work practice and being upheld in written recordings.  

The Social Worker will engage in Advance Care Planning for assigned residents upon admission, and make sure that any Advance Directives are reviewed with the resident/resident representative on a regular basis.  The Social Worker will ensure that staff members are made aware of the resident’s code status and end-of-life wishes and will assist with informing and educating residents and their representatives about health care options and ramifications. 

The Social Worker will assist with facility policy development and annual review in order to positively impact the quality of care delivered to residents.   

The Social Worker will assist the Social Services Director in ensuring that staff members are knowledgeable about Resident’s Rights and encourage staff to maintain and enhance each resident’s dignity in recognition of each resident’s individuality.   

The Social Worker will advocate for residents and assist them in assertion of their rights within the facility.  When there is an allegation of suspected abuse, neglect or exploitation, the Social Worker will report to the Social Services Director and/or Administrator and assist with reporting to the appropriate State agency, as well as completion of a thorough investigation as assigned.  

The Social Worker will ensure that residents who display mental illness, or psychosocial difficulties such as coping with grief and loss, have access to appropriate treatment and resources.  

In the absence of the Social Services Director, the Social Worker will assume the authority, responsibility, and accountability of directing the Social Services Department.  

Additional Assigned Tasks 

• Treats all residents with dignity and respect.  Promotes and protects all residents’ rights. 

• Establishes a culture of compliance by adhering to all facility policies and procedures.  Complies with standards of business conduct, and state/federal regulations and guidelines. 

• Follows appropriate safety and hygiene measures at all times to protect residents and themselves. 

• Maintains confidentiality of protected health information, including verbal, written, and electronic communications. 

• Reports noncompliance with policies, procedures, regulations, or breaches in confidentiality to appropriate personnel.  Reports any retaliation or discrimination to HR or compliance officer. 

• Reports any allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to supervisor and/or administrator.  Protects residents from abuse, and cooperates with all investigations.   

• Reports any occupational exposures to blood, body fluids, infectious materials, and/or hazardous chemicals in accordance with facility policy.   

• Participates in all life safety and emergency drills and trainings.  Fulfills responsibilities as assigned during implementation or activation of the facility’s emergency plan. 

• Reports work-related injuries and illnesses immediately to supervisor. 

• Follows established infection control policies and procedures. 

• As a condition of employment, completes all assigned training and skills competency. 

• Interviews residents and/or their responsible party to obtain the resident’s social history. 

• Makes arrangements for residents to obtain items such as clothing and personal care supplies. 

• Assists residents obtaining transportation to medical appointments, upon discharge, etc. 

• Acts as a resource for staff participating in behavioral interventions with residents.  

• Assists residents in voicing and obtaining resolution to grievances.  Reviews complaints and grievances made by the resident and make a written/oral report to the Social Services Director and/or Administrator indicating what action(s) were taken to resolve the complaint or grievance.  Follow facility’s established procedures. 

• Participates in Resident and/or Family Council as needed or requested.  

• Assists with, or arranges for, a resident’s communication of needs through the resident’s primary method of communication or in a language that the resident understands. 

• Coordinates Social Service activities with other departments as needed.  

• Maintains confidentiality of protected health information, including verbal, written,  

• Performs administrative requirements, such as completing assigned reports, and submit them to the Social Services Director as required. 

• Contributes to the facility efforts to maintain and/or improve quality of care through participation in the following: 

• Attends Care Plan meetings. 

• Serves as a member of the QAPI Committee if requested. 

• Serves as a member of the Behavior Management Committee if requested. 

• Attends Department Head/Stand Up Meetings. 

• Attends mandatory in-services.  

• Successfully completes the facility required training, and any Social Work continuing education and licensing requirements.