Medical Social Worker II Full Time 40 hours -Homecare & Hospice

At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet ® and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

Job Summary:

Under the direction of the Social Work Director or Operations Manager of Home Care Services, provides services to patients and families geared to enhancing functioning and to addressing psychosocial problems which interfere with recovery from illness or prevent a healthy lifestyle.  Provides consultation to other health care providers to help them deal with psychosocial problems interfering with compliance with treatment regimen.  Participates in community activities to insure resource availability for patients/families.

Essential Job Functions and Responsibilities:

Utilizes social work skills.

Identifies "high risk" patients with a wide variety of psychosocial problems that may inhibit patients recovery or well-being.

Utilizes appropriate clinical techniques to establish rapport and effective relationships to facilitate work with patients and families on a timely basis.

Obtains pertinent data including social history, living arrangements, relationships and support systems, occupational and financial and other information.  

Evaluates data, assessment, identifies strengths and weaknesses, and problems areas with regards to treatment plans and keeps health care team aware of information.

Utilizes assessment to make appropriate interventions to enable patient/family to cope with problems including, but not limited to grieving over loss of limb or other body part; adjustments necessitating changes in lifestyle due to sudden and/or chronic illness; guilt of adult child placing aged parents in ECF, abandonment feelings of patient being placed; financial burdens, etc.

Involves patient/families in understanding alternatives and planning and deciding about post-hospitalization care and facilitating their adjustment to and motivation for participating in plan.  

Advocates on patient's/family's behalf for recognition of their individual needs and for necessary services to address needs.  

(+) Provides crisis intervention services for patients undergoing emotional, social distress.

Coordinates discharge planning needs and policies.

Identifies and responds to patients in need of discharge planning within 24 working hours of referral.  

Completes psychosocial and environmental assessment including key social supports available, patient situation and strengths and weaknesses.  

Provides counseling to patient/families to enable adaptation to impact of illness.  

Involves patient/family in all aspects and decisions in discharge planning process.

Carries out case management services to assure appropriate linkage and coordination with patient/family and available hospital departments, agencies, services and facilities on a timely basis.  

Interprets entitlement program policies, criteria and limitations to others involved in planning.

Locates the least restrictive post-hospital environment based on assessment of patient's needs, capabilities and preferences.  

Provides technical assistance, completion of ECF or Title XIX applications, etc.  to facilitate discharge plan.  Initiates, attends and participates in interdisciplinary case conferences.

Facilitates patient transitions to new environment, helping patient/family cope emotionally and assuring necessary information and coordination of transportation, etc.

Adheres to hospital policy and regulatory requirements that impact on planning.

Provides assistance in resource utilization.

Provides accurate information on resource availability and criteria for utilization.  Seeks out resources when availability not known and shares information with other department members.

Explores entitlement program eli