- Develops an individualized documented plan of care reflecting patient/family goals and provides social work services as outlined in the plan of care
- Identifies and monitors potential psychosocial hot spots.
- Provides co-case management support for issues related to care giving, advance directives, funeral planning, community resources and insurance benefit oversight
- Provides co-case management support for issues related to grief and loss, family dynamics and psychosocial history
- Exercises professional expertise in managing and coordinating care between and among involved parties in home, SNF and RCFE setting
- Respects patient right to self-determination and acts as an advocate within the context of the vision, mission, values and ethical standards of HSCC.
- Assists Admission department with resourcing, assessment, information and registration process as requested
- Ensures documentation is accurate, organized, legible, and a complete reflection of services provided as well as an interdisciplinary approach to care. Utilizes only approved abbreviations to ensure clarity of documentation
- Demonstrates the ability to articulate the parameters of hospice care and services
- Demonstrates the ability to work with patients/families under stress and in crisis
- Demonstrates understanding of Hospice Medicare/Medi-Cal Benefit and third party payors
- Demonstrates professional demeanor, tact, and respect in dealing with all patients, families, staff and volunteers
- Responds with flexibility to the changing needs within the assigned caseload
- Participates in weekend and holiday Social Work coverage.
- Performs other related job duties as assigned by Supervisor
- Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, State and Federal Laws and all other regulatory/compliance requirements are understood and followed
- Submits verification of MSW degree from accredited school, passes OIG/GSA and background checks
- Signs Vehicle Insurance Acknowledgement upon hire and maintains a good driving record
- Insures TB checks are completed in a timely manner; at least annually
- Provides visit frequencies that are within established agency standards
- Follows all requirements for obtaining approval for overtime
- Completes Psychosocial Assessment in a timely manner as required by performance standards
- Provides concise and timely reports to appropriate team members as required by standards
- Documents in a timely manner, all activities and services provided using electronic medical records systems
- Submits completed time logs within the required time frames
- Meets all standards and requirements as indicated by licensing and accrediting agencies
- Participates in continuing education opportunities both within and outside the agency
- Participates in activities that affirm, enhance and develop the highest quality standards for HSCC
- Participates in Quality Assessment & Improvement activities as requested
- Participates in special projects as requested.
- Master of Social Work (MSW) degree required from a school of social work accredited by the Council on Social Work Education.
- Minimum of 1 year of Social Work experience in a healthcare setting required
- Prefer previous experience in hospice or other end-of-life care and services
- Solid experience and/or aptitude with computer systems and electronic medical record systems and charting
- Strong verbal and written communication skills
- Skilled in tact and diplomacy
- Capable of bringing appropriate level of sensitivity and compassion to patients/families facing terminal illness, death and bereavement
- Understands how to hold and apply appropriate boundaries for care
- Knowledge of community social work services, resources and operational standards
- Understanding of all applicable laws and regulations related to social work licensing
- Understands and utilizes solid ethics in decision making and activities
- Bilingual in English/Spanish highly desirable
- LCSW or related license desirable but not required
- Ability to travel to patient locations; includes ability to drive, negotiate stairs and walkways including uneven surfaces at private homes or facilities.
- Sufficient dexterity to utilize electronic record keeping systems, computers/keyboards and/or laptops and other related equipment
- Vision ability to read manual and electronic documentation, charts, office related equipment, instructions
- Hearing ability within normal range to elicit and detect pertinent information while communicating with patients and health team
- Speech to verbally communicate to assess and impart information concerning patient status; to complete patient/family teaching and to interact with health care team
- Performs services in private homes and care facilities and will experience a variety of settings and situations.
- Office work is performed in typical office setting.
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Social Worker - Scotts Valley, United States - Hospice of Santa Cruz County
Description
The Hospice Per Diem Social Worker is a member of the Variable Staffing Team and is responsible for the co-case management of hospice patients and families. In collaboration with patient/family, physician and interdisciplinary team, develops and coordinates an individualized Plan of Care (POC) that reflects patient/family centered goals related to Safe & Comfortable Dying, Self-Determined Life Closure, and Effective Bereavement. Also addresses the multiple psychosocial issues that affect Hospice patients and their families/caregivers.
Essential Responsibilities
Patient and Family Care/Case Management
Functions as a member of the IDT maintaining open & organized communication with hospice staff, volunteers and supervisor.
Functions as social worker for hospice patients/families in the coordination/provision of care.
As needed, participates in IDT meetings in a manner that promotes problem solving, care planning and learning.
Quality Improvement
Education