Licensed Social Worker at Webster

Focused Post Acute Care Partners•Webster, TX

2d•Onsite

About The Position

Focused Post Acute Care Partners is seeking a Licensed Social Worker for Focused Care at Webster in Webster, Texas. The Social Worker uses knowledge of community resources and professional judgment to serve as a primary referral source for residents. The role involves interviewing residents, coordinating and referring them to appropriate resources, and promoting activities that support residents’ social and emotional needs and, when appropriate, those of their families. The position works closely with facility administration, medical and nursing staff, other departments, residents, responsible parties, and community agencies to maintain and deliver social services in a long-term care setting. The position is scheduled as assigned, including some weekends, evenings, and holidays, and is non-exempt. The role requires the ability to respond appropriately to emergency situations and to perform physical movements including pushing, pulling, lifting, bending, kneeling, and reaching, with lifting up to 50 pounds, with or without reasonable accommodations.

Requirements

Bachelor’s degree in Social Work or a Human Services field, including Sociology, Gerontology, Special Education, Rehabilitation Counseling, or Psychology.
Must be a licensed Social Worker in Texas or obtain licensure within six months of hire.
Ability to react appropriately to emergency situations when required.
Ability to safely push, pull, lift, bend, kneel, and reach, including lifting up to 50 pounds, with or without reasonable accommodations.

Nice To Haves

Two years of experience in long-term care, a hospital, or another related medical facility is preferred.

Responsibilities

Meet with administration, medical and nursing staff, and other departments to plan social services.
Advocate for residents and help ensure their rights are maintained.
Report abuse, neglect, or exploitation according to state reporting guidelines.
Maintain professional working relationships with the facility interdisciplinary team and community resources and agencies.
Complete Social Service History and Social Service Evaluation for newly admitted residents within 14 days.
Complete sections B, C, D, E, and Q of MDS 3.0 on days 5, 14, 30, 60, and 90; annually; upon a change of condition; and upon readmission from hospitalization.
Educate residents about and assist with Advance Directives, Medical Power of Attorney, and Out of Hospital Do Not Resuscitate documents.
Facilitate referrals to ancillary services, including optometry, audiology, dental, podiatry, counseling, psychiatry, and psychological testing; coordinate follow-up, physician orders, and information transfer to service agencies.
Explain palliative care and hospice care to residents and responsible parties and assist with referrals, transitions, and end-of-life decisions.
Obtain prior authorization numbers for Medicaid residents who need ambulance transportation to non-emergency medical appointments.
Assist with scheduling transportation for residents’ medical appointments.
Prepare a Social Service Evaluation before each resident care plan to assess changes and areas of need since the previous care plan.
Document resident and responsible-party interactions, assessments, assistance provided, and issue resolution.
Support discharge preparations throughout residents’ stays and coordinate requested or required community services.
Prepare care plans addressing advance directives, DNR status, personal preferences, and behavioral or psychosocial issues.
Facilitate resident room changes, including required five-day relocation notices, follow-up with residents and relevant parties, and documentation.
Review residents’ psychosocial wellbeing following the loss of a family member, friend, or roommate.
Attend Resident Council meetings when invited by Council members and assist with resolving issues raised.
Facilitate grievance procedures and help maintain the facility Monthly Grievance Log.
Attend Performance Improvement / Quality Assurance meetings quarterly and provide information on resident referrals, behavioral issues, and grievance trends from the prior quarter.
Review all resident charts biannually to ensure assessments, documentation, directives, and care plans are current, consistent, and properly placed.
Maintain knowledge of federal and state long-term care regulations and professional standards.
Develop and maintain working relationships with facility personnel, community health and welfare organizations, and social agencies.
Recommend policy and procedure changes to the department director or Administrator as appropriate.