About Job
2. Must be available to discuss the POC with the admitting RN on the day of admission for new patients.
3. When requested by the patient/family, conducts regular social work visits and documents the assessment, interventions and outcomes of the visit.
4. Assists patients and families as needed with insurance needs. Upon admission evaluates insurance coverage and helps with obtaining Medicaid or other insurance coverage when the patient does not have a payer source.
5. Coordinates with the Volunteer Coordinator in requesting and monitoring volunteer services.
6. Participates in the IDT Meeting and updates the POC at least every 14 days. Acts as consultant to hospice program staff.
7. Communicates all changes in the patient's level of care status to the Patient Care Coordinator.
8. Participates in discharge planning. Responsible for facilitating discharge and transfer of patients to other healthcare providers when hospice care is no longer requested or appropriate, and completes the appropriate paperwork.
9. Participates in the Quality Improvement Process and evaluation of social services.
10. Identifies psychosocial problems and establishes goals that are pertinent, personalized, and measurable as evidenced by documentation in the Electronic Medical Record.
11. Demonstrates knowledge of the Hospice Benefit and is able to convey that knowledge to patients and families.
12. Conducts the after death bereavement assessment. With the Chaplain makes bereavement telephone calls to caregivers. Initiates bereavement telephone calls to follow up with families (after 1 week; 2 months; 6 months and 12 months) following the death of a patient.
13. Explains Advanced Directives to Patients/Families and communicates and documents patient decisions to the patient's attending physician.
14. Assists patient/family with making funeral arrangements, as needed.
15. Assists with community outreach by providing in-services and/or other forms of education related to hospice care in the community as planned with the Hospice Administrator and other IDT members.
16. Documents patient and family response to psychosocial interventions in an accurate, and timely manner and is completed in the Electronic Record. Transfers of electronic information must be completed at least twice daily.
17. Delivers or supervises the delivery of social services to the patient and/or family. Knowledgeable of federal, state and local/community resources for patients, when appropriate, and assists patients/families in identifying and accessing these resources. Maintains and updates regularly a Social Work Community Resource Guide with a current copy maintained in the office, with the Administrator and electronically.
18. Attends staff meetings to remain current in hospice policies and procedures, as evidenced by attendance roster.
19. Communicates with other team members concerning changes in patient condition and gives accurate reports on assigned patients.
20. Reports any changes in the emotional, social, or financial condition of the patient or family to the attending physician; and documents interventions. Obtains physician's orders for services, as necessary.
21. Must be willing and available in an on-call rotation to make after hours visits (i.e. on weekday evenings or on the weekend) when needed for a patient's death, funeral, or admission, etc. or psychosocial crisis.
22. Reviews and updates the plan of care (POC) as often as necessary.Qualifications
- Tennessee and Missouri = MSW preferred, minimum BSW required
- Virginia = MSW preferred, BSW required and two years experience
- South Carolina = Social Work Licensure Required; LMSW required
- Georgia = Social Work Licensure required; LMSW preferred, Min. LBSW required
- If minimum requirement is a Baccalaureate degree in Social Work. This is only available as long as Caris is able to arrange ongoing supervision and oversight by an MSW
- One (1) year of social work experience in a health care setting.
eQuest
Professional Field


Patient Focus
Diagnoses
Avoidant Personality Disorder
Therapeutic Approach
Methodologies
ECT
Modalities
Families
Practice Specifics
Populations
Racial Justice Allied
Settings
Hospice
In-patient Non-Psychiatric
In-patient Psychiatric
Research Facilities/Labs/Clinical Trials
Home Health/In-home
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