Social Worker (Per Diem)

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

• 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

Compliance

• 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

Productivity

• 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

IDT Participation

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

• 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

Special Projects

• Participates in special projects as requested.

Requirements

Education

• Master of Social Work (MSW) degree required from a school of social work accredited by the Council on Social Work Education.

Experience

• 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

Skills Desired

• 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

Certifications, Licenses, Registrations

• LCSW or related license desirable but not required

Physical Demands

• 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

Work Environment

• 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.