Clin Social Worker

AHMC Healthcare•Daly City, CA

About The Position

The Social Worker provides psychosocial support to residents to help them attain or maintain their highest practicable well-being. The role contributes to resident assessment, care planning, coordination of services, and, when applicable, discharge planning. The Social Worker collaborates with the interdisciplinary team, families, and community partners to provide ethical, patient-centered care in compliance with applicable regulations and facility requirements. The position supports residents’ emotional, mental, and psychosocial needs; advocates for residents’ rights and dignity; coordinates admissions and discharge services; supports advance care planning; and maintains accurate documentation. It also involves resident engagement and daily support, interdepartmental collaboration, staff education, participation in quality improvement activities, and completion of required training. The Social Worker may assist with policy development and assume leadership of the Social Services Department in the Director’s absence.

Requirements

Minimum of 1 year of experience in social services and discharge planning.
Strong knowledge of CMS Conditions of Participation, CDPH standards, and Title 22 requirements.
Proficiency in Google Docs.
Excellent verbal, written, and interpersonal communication skills, with the ability to exercise sound judgment.
Demonstrated leadership, organization, teamwork, and problem-solving abilities.
Ability to work effectively in a multidisciplinary, fast-paced environment and maintain composure under stress.
Ability to make independent decisions and interact tactfully with residents, families, staff, and regulatory personnel.
Ability to coordinate meetings, set goals, and manage tasks efficiently.

Nice To Haves

Experience working with an EMR/PCC system.

Responsibilities

Complete social service assessments and contribute to individualized care plans that address residents’ emotional, mental, and psychosocial needs.
Encourage residents and families to participate in care planning meetings.
Assist with preadmission evaluations and required screenings.
Coordinate safe and effective discharge planning, including community services, follow-up care, and access to financial, legal, and social resources.
Identify and communicate residents’ social, emotional, and psychological needs to the care team.
Advocate for residents’ rights and dignity, assist with grievances, and support access to appropriate mental health and psychosocial resources.
Maintain timely, accurate, complete, and professional documentation.
Ensure compliance with federal and state regulations, facility policies, HIPAA, Title 22, CMS conditions of participation, and social work ethical standards.
Support residents and representatives in understanding and completing Advance Directives, and ensure staff are aware of residents’ code status and end-of-life preferences.
Protect resident privacy, follow infection control and safety procedures, and report abuse, neglect, policy violations, workplace injuries, and other incidents according to facility guidelines.
Obtain social histories and assist residents with personal needs such as supplies, clothing, and transportation.
Support residents’ communication needs and serve as a resource for behavioral interventions.
Coordinate Social Services activities with other departments and participate in care plan meetings, psychotropic reviews, and required facility meetings.
Educate and support staff regarding psychosocial issues, trauma-informed care, and patient rights.
Support facility QAPI initiatives by participating in audits and data collection as needed.
Complete required training and continuing education.
Assist with policy development and assume leadership of the Social Services Department in the Director’s absence.