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Description Applies professionally accepted, research based practices, such as Person-in-Environment holistic approach. Works cooperatively as part of the management team to develop resident-centered approaches to all center quality of care and quality of life activities. Resident advocacy responsibilities as needed to achieve or maintain a dignified existence for all residents. Essential Functions:
- Develops and/or delivers culturally-sensitive training to all disciplines to meet the psychosocial needs of the residents. Utilizes classroom training and spontaneous "on the floor" training opportunties.
- Participates in new employee orientation, including but not limited to education on resident rights, abuse/neglect, behaviors and culture change/resident-centered care.
- Develops and maintains a comprehensive list of services in the community (such as dentists and eyeglass repair shops that accept Medicaid). The list is available for use by center staff in obtaining needed services for residents and by residents and families upon discharge.
- Social Services Specialists that are the department heads participate as members of the Performance Improvement Committee
- Level I may be an assistant and takes direction from Social Services Manager or Specialist II or III.
- Works with the resident, family/significant others and other team members to outline goals of stay at admission, the plan to meet those goals and discharge as appropriate.
- Provides educational materials to resident and/or family/significant others related to advance directives; assists them in completion of advance directives as desired by resident and/or family/significant others.
- Encourages involvement in family council, and assists family council with meeting arrangements.
- Works with the Executive Director and Director of Nursing to determine root cause of complaints/concerns and develop ethical solutions.
- Maintains professional networking relationships in the community with other social service organizations. Examples of such organizations include but are not limited to local chapters of National Association of Social Workers and local provider groups of social workers in hospitals or care management groups.
- Assists resident/family/significant others in obtaining appropriate forms to gain services, such as Medicaid applications or insurance appeals
- Advocates for the resident and with the resident, exploring possible compromises that keep the resident's best interest in mind. Examples of such activities are:
- Educating the resident/family about the impact of going home before treatment goals are met. Following up with resident/family in the event of premature discharge, to avoid unnecessary rehospitalization.
- Mediating therapy compliance to help resident meet personal goals, when noncompliance is an issue.
- Advocating for appropriate room placement upon admission to help avoid unnecessary room moves.
- Encourages interdisciplinary, resident and family involvement in a quality of life advisory committee.
- Provides direct psychosocial intervention to residents and residents' families/significant others.
- Assists resident's families/significant others in coping with skilled nursing placement, physical illness and disabilities of the resident, and the grieving process.
- Responsible for timely completion of psychosocial assessments, screening instruments, relevant MDS sections and RAPS.
- Primary liaison with psychological and psychiatric service providers.
- Creates integrated, person-centered care plan based on strengths and preferences of the resident. Periodically evaluates the care plan for effectiveness of interventions; updates care plan as needed.
- Documents observations and events in the resident's medical record as needed; assesses and documents psychosocial impact of life events, health concerns and condition change.
- Facilitates interdisciplinary review of distressing behaviors exhibited by some residents, utlizing a holistic approach to resolve concerns.
- Facilitates interdisciplinary review and reduction attempts of psychotropic drug use
- Collaborates with Activities Department to develop activities and psychosocial interventions that support resident independence and recovery.
- Performs other tasks as assigned.
- Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
- Ability to work cooperatively as a member of a team.
- Builds rapport quickly with peers and customers
- Ability to maintain confidentiality.
- Creative problem-solving skills
- Knowledge of accepted standards of practice for long-term care social workers.