Social Services Assistant

Key Responsibilities

Coordinates resident transfers and discharges. a. Prepares cases for review for Executive Director, Director of Social Services, Director of Nursing and team. b. Serves as transfer/discharge planner, arranges meetings. c. Arranges cases for review of facility staff. d. Documents transfer/discharge plan. e. Arranges transfer/discharge planning meetings as necessary. f. Maintains a list of agencies that can assist residents and families with their discharge plans.

Completes assessments of residents as necessary for Care Planning, MDS, CAAS, PPS and other required documents. Identifies, provides and/or coordinates for the medically-related social, psychological and spiritual needs of the residents.

Develops Care Plans and attends Interdisciplinary Care Conferences for residents. a. Serves as resident advocate. b. Coordinates invitation of residents and families. c. Refers to Volunteers of America National Services Care Planning and MDS manuals to complete required sections. d. Implements described case management, counseling or support described in Care Plan. e. Maintains confidential records as necessary. 4. Initiates reporting and documentation in the medical record. a. Maintains accurate and appropriate social service documentation in the medical record, including electronic medical record. b. Completes and updates assessments and documentation per Volunteers of America National Services social work policy and State/Federal regulations. c. Prepares written summaries of conferences and meetings as necessary. d. Notifies admissions coordinator or business office of payer change status for daily census.

Develops and promotes the department through marketing efforts throughout the professional and social community. a. Maintains a current Community Resource and Advocacy Agency File. b. Visits referral agencies and local hospitals to share information on facility. c. Provides community resource information to residents and families relating to alternative health care services or facilities, clinics, etc. d. Plans and presents sessions to community and professional groups on the facility and on the problems of aging and adjusting to long-term care facility life.

Serves on committees as required by Social Services Director.

Attends/coordinates family council/educational meetings and resident council.

Serves as rights advocate liaison to the facility; coordinates posting of all Federal and State required material for resident and family advocacy and updates materials as necessary.

Advises the Director of Social Services of major problems or concerns of residents or their family members; recommends solutions and follows concern-problem resolution process.

Ensures that residents have necessary and adequate clothing, health aids, etc.

Coordinates resident admissions. a. Takes pre-admission calls and manages a waiting list as necessary. b. Offers tours to prospective customers and admissions. c. Conducts pre-admission screening: (1) per phone; (2) in hospital or at referring long-term care facility; (3) at prospective resident’s home. d. Meets with all new residents. e. Completes admission documents. f. Advises residents and families of advance directive policies.

Develops statistics on operation of department; develops and maintains admission/discharge/ referral/inquiry statistics, as required.

Assists with education to residents, families, staff, etc. on topics such as bill of rights, vulnerable adult, advance directives, etc.

Assist with and coordinates information and referral for residents (e.g., finances, counseling, support services, mental health, etc.).

Attends required in-services and completes assigned online modules.

Performs other duties or special assignments as directed by the Director of Social Services.