Social Worker - Discharge Planner

Elderwood•Lancaster, NY

3d•Onsite

About The Position

As a Social Worker - Discharge Planner, you will play a vital role in supporting residents and families throughout their healthcare journey. This position focuses on helping residents achieve the highest possible quality of life by addressing psychosocial, emotional, and discharge planning needs within a skilled nursing and rehabilitation environment. You will serve as an advocate, resource, and guide for residents and families - helping navigate transitions of care, coordinating supportive services, and fostering dignity, independence, and meaningful resident-centered outcomes. The ideal candidate is compassionate, organized, and committed to building strong relationships with residents, families, interdisciplinary teams, and community resources. This role offers the opportunity to make a lasting impact by supporting residents through rehabilitation, long-term care planning, emotional support, and safe, successful discharge transitions.

Requirements

Minimum of a bachelor’s degree in social work or a bachelor’s degree in a human services/ field including, but not limited to, sociology, gerontology, special education, rehabilitation counseling, and psychology from an accredited institution.
One year of supervised social work experience in a health care setting working directly with individuals
Experience in casework required.
Valid Drivers License and clean driving record required.
Desire and ability to work with the elderly and to cooperate with other staff members necessary.
This position requires regular interaction with residents, coworkers, visitors, and/or supervisors.
In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.

Nice To Haves

Work experience in the admission or discharge area of social work very desirable.

Responsibilities

Assumes a social work caseload of all residents on a nursing unit according to policies and procedures described in Section B of the Social Services Manual.
Greets and helps acclimate new residents.
Assists with development and review of plan of care to meet the long and short range health care goals for individual residents on the assigned nursing unit.
Completes SCREEN form for new admissions to unit and for discharge process if applicable.
Takes an active part in decisions and procedures regarding discharge or transfer of residents to another level of care.
Documents pertinent information regarding residents as required by department and facility policies and procedures.
Cooperates with staff of other departments in meeting the physical, emotional and social needs of residents.
Provides financial, personal, or group counseling for residents and their family members or sponsor.
Participates in in-service training programs upon request.