Social Worker, BSW or MSW

Abides by and supports 3HC's Compliance Program and Code of Ethics. 3HC's Compliance motto is "Compliance for all and all for Compliance". It is the intent of 3HC to comply with all applicable laws and regulations and that spirit is embedded in all aspects of our services and business practices. Our success hinges on doing things ethically and legally, to which, each and every employee plays a critical role.

Creates positive experiences for internal and external customers that will meet their expectations. (External customers include our patients, families, referral sources, vendors, the community, etc. Internal customers are the people within the agency with whom you work.) Displays a high degree of courtesy, tact, and knowledge of services provided by the agency in all contact with staff, patients, and visitors.

Manages assigned cases and assists office with achieving positive patient outcomes: (a) provides social work care as outlined in the physician's plan of treatment, according to 3HC's policies and procedures and as allowed by the institution accredited by the Council on Social Work Education; (b) consults with the attending physician concerning alteration of the plan of treatment and documents, in writing, appropriate change of orders where necessary, (c) acts as a liaison between the Hospice program and community agencies for bereavement services; (d)involves the patient/family in plan of care and addresses patient/family questions and issues, (e) evaluates patient/family response to intervention(s) when referred to community agency and satisfaction of the service(s) provided and response to psychosocial interventions; (f) identifies obstacles to compliance and assisting in understanding goals of interventions, and identified patient/family needs when discharged or when level of care changes; (g) evaluates long-term care when appropriate and assesses ability to accept change in level of care, (h) communicates psychosocial information to inpatient facility when care level changes, and (i) assesses needs for counseling related to risk assessment for pathological grief and evaluates patient/family response to psychosocial interventions.

Conducts a complete assessment of the patient to identify appropriate care needs: (a) assesses caregiver's ability to function adequately, (b) evaluates social needs of patients and families by arranging interviews, making evaluation and follow-up home visits as indicated in the plan of treatment and allowed under reimbursement guidelines and assessing the financial resources of the patient/family when appropriate in relation to medical and health needs. Psychosocial Assessment; (c)assesses emotional factors related to terminal illness, the patient/family psychosocial status, potential for risk of suicide, abuse, and/or neglect, environmental resources and obstacles to maintain safety, and special needs related to cultural diversity including communication, space, role of family members and special traditions. Psychosocial and Pre-bereavement Assessments, (d) identifies family dynamics and communication patterns, the development level of patient/family and obstacles to learning or ability to participate in care of patient, and support systems that will be available to reduce stress and facilitate coping with end-of-life care; (e) assist the physician and other IDG members in recognizing and understanding the social/mental stress and/or disorder that exacerbates the symptoms related to terminal illness, (f) ensures on-going bereavement care and updates care plan, per agency policy, (g) provides social service such as short-term individual counseling, crisis intervention, assistance in providing information and preparation of advance directives, funeral planning issues and transfer of responsibility regarding fiscal, legal, and health care decisions; (h) set goals related to the needs of the patient/family and (i) assists in discharge planning as directed by the home health team.

Responsible for developing, utilizing and maintaining relationships with appropriate community resources, and assesses patient/family ability to access them by making referrals and finding alternatives to home health care when indicated.

Responsible for evaluating caregiver for high risk bereavements and completes a face to face bereavement assessment within 7 days after patient's death.

. Participates in IDG and ITC meetings, etc. to develop and revise the plan of care and assure that the psychosocial needs of the patient are given consideration and provides consultation to team members regarding specific problems. In regard to Hospice patients, reports updates on volunteer and spiritual care.

Responsible for assessing bereavement needs and developing a care plan within six weeks of patient's death.

Actively assists Bereavement Coordinator for the Hospice program ensuring that assessment, follow-up, supervision, counseling, and record keeping is completed according to Hospice policy and procedure.

Performs Performance Improvement studies as requested

Maintains knowledge of regulations pertaining to area of responsibility.

Stays abreast of overall patient care and improves social work skills: (a) participates in office staff meetings, patient care conferences, record audits, utilization reviews, quality improvement activities, and in-services; (b) attends and participates in interdisciplinary team conferences at least 75% of the time; (c) attends agency mandatory in-services and satisfies CEU requirements; and (d) strives to improve social work care through continuing education, active participation in professional and related organizations and individual research and readings.