Rehab Social Worker

St. John's Senior Services•Rochester, NY

27d•Onsite

About The Position

St. John’s is leading and inspiring a shift in society’s views of elderhood. Join our family of dedicated, talented employees who are at the forefront of innovative senior services delivery in this community. St. John’s embraces living every day by fostering a culture that is friendly, respectful, responsive, compassionate, innovative, and fun for both employees and the elders and residents that call St. John’s home. If this description speaks to you, continue reading about the opportunity of Social Worker. This is a full-time, 40 hours per week Monday-Friday day position at St. John’s Home. Position Summary: The Social Worker assesses and supports psychosocial well-being of elders in admission, discharge and during daily life at St. John’s. This valuable role supports 80-90 long term care residents. This team member ensures that the interdisciplinary team is honoring resident rights and facilitates appropriate placement supports on the neighborhood. Upon admission and throughout the course of the residents stay, coordinates the interdisciplinary team to ensure goal alignment and individual planning for each resident’s specific needs. This role must show a commitment to innovative solutions, elder directed goal setting and frequent family support is imperative.

Requirements

Minimally a bachelor’s degree in social work or related field, MSW preferred.
Minimum one year experience in a health care setting, with knowledge of long-term care, insurance coverage, discharge planning and end of life care.
Frequent moving and lifting, pushing, pulling and bending.
Frequently squatting and occasionally reaching.
Exposure to Conditions: May be exposed to infectious diseases and physical aggression

Nice To Haves

Experience in the field of Gerontology and Screen certification a plus.

Responsibilities

Assess and support well-being in admission, discharge, and during daily life at St. John’s.
Performs casework counseling services for elders and family members/responsible parties in specifically assigned areas, being mindful of the need to advocate for resident rights and wishes.
Continual assessment and documentation of elder’s needs, which include evaluation for depression, changes in mental status, anxiety, family dynamics/crises and interpersonal interactions with family, staff and other elders.
Assist with discharge planning, transfers and transition by arranging for appropriate community services and completion of all corresponding paperwork.
Completes appropriate referrals for Hospice, CHE Psychological Services, ElderPlan etc.
Assumes responsibilities for designated committees or projects of the department or facility as requested.
Oversees creation of meaningful elder experience through facilitating communication between staff, elders and families.
Assist with admission process through supportive contacts as elders adjust to the new environment, complete initial assessments and all corresponding admission paperwork.
Completes corresponding paperwork for hospital transfers and internal moves within the community.
Assure that documentation is in accordance with facility and regulatory agency guidelines.
Actively participates in care rounds weekly and communicates changes ongoing.
Provides emotional support to elders and families in time of grief.
Completes grievance forms and communicates with the care team regarding concerns and complaints voiced by residents and family.
Facilitates conferences – discharge planning, initial, annual and significant change family meetings and any care team conferences.
Creates and regularly updates comprehensive care plan, in addition to completing routine MDS assessments.