FT MSW 30 Bed Long Term Care

Full Time 32 hours/week. Monday - Friday Preferred Hours 9am-5pm. Flexible Schedule

The Social Worker promotes the psychosocial well-being, dignity, rights, and quality of life of short-term rehabilitation and long-term care residents. Working collaboratively with residents, families, and the interdisciplinary team, this position provides psychosocial assessments, individualized care planning, resident advocacy, discharge coordination, resource referrals, and support with resident and family concerns.

The Social Worker serves as a resource and advocate, helping residents and families navigate changes in health, independence, living arrangements, and care needs while ensuring compliance with facility policies and applicable federal and Connecticut regulations.

Our ideal candidate is a compassionate and accountable professional who excels at resident and family advocacy, possesses exceptional communication and relationship-building skills, and demonstrates the strong organizational detail, collaborative problem-solving, and professional judgment required to advance quality improvement and appropriately address concerns.

We are an Equal Opportunity Employer

EEO/AA/M/F/DV

• Psychosocial Assessment and Care Planning: Complete admission assessments, reassessments, quarterly documentation, and applicable MDS assessments. Evaluate psychosocial needs, identify concerns such as depression, anxiety, grief, and social isolation, and develop and update individualized care plans in collaboration with the interdisciplinary team.
• Resident and Family Support: Establish supportive relationships with residents and families, providing guidance regarding changes in health, adjustment to long-term care, goals of care, placement options, and end-of-life concerns. Promote resident dignity, autonomy, privacy, confidentiality, informed choice, and participation in care decisions.
• Resident Advocacy and Grievances: Receive, document, investigate, and coordinate the resolution of resident and family grievances. Address concerns, facilitate communication, support resident engagement, coordinate room changes, participate in monthly Resident Council meetings, and assist with voter registration.
• Admissions and Discharge Planning: Assist with admissions, prospective resident tours, admission paperwork, PASRR screenings, continued-stay screenings, and required documentation in Ascend. Initiate discharge planning early, identifying barriers and coordinating safe transitions through appropriate referrals for home care, durable medical equipment, hospice, and community-based services.
• Resource and Insurance Coordination: Assist residents and families in accessing Medicare, Medicaid, insurance benefits, financial assistance, aging services, caregiver support, behavioral health services, and other community resources. Coordinate applicable Medicare notices, including NOMNC, and communicate appeal rights in collaboration with appropriate personnel.
• Interdisciplinary Collaboration: Work closely with nursing, rehabilitation, activities, dietary, admissions, finance, providers, and administration to coordinate resident services, participate in care conferences and weekly disposition meetings, and communicate discharge readiness and follow-up needs.
• Documentation and Regulatory Compliance: Maintain timely, accurate, and confidential documentation of assessments, care plans, referrals, grievances, family meetings, admissions, and discharge activities. Ensure compliance with resident rights, facility policies, and applicable federal and Connecticut regulations.
• Quality Improvement and Safety: Participate in staff education, quality improvement initiatives, surveys, audits, and corrective action activities as assigned. Identify opportunities to improve resident and family satisfaction and promptly report suspected abuse, neglect, exploitation, mistreatment, or resident safety concerns through required channels.

Qualifications

Required:

• Master's degree in Social Work (MSW) from a Council on Social Work Education (CSWE)-accredited institution.
• Minimum of one year of social work experience in a healthcare setting.
• Knowledge of psychosocial assessments, resident rights, individualized care planning, discharge coordination, and long-term care regulations.
• Strong interpersonal, communication, organizational, documentation, problem-solving, and conflict-resolution skills.
• Ability to maintain confidentiality, exercise sound professional judgment, and manage sensitive situations.
• Ability to work independently, prioritize competing responsibilities, and collaborate effectively with an interdisciplinary team.

Preferred:

• Experience in skilled nursing, short-term rehabilitation, nursing home, or long-term care settings.
• Familiarity with Medicare, Medicaid, PASRR, MDS, Ascend, and community-based resources.
• Experience coordinating discharge plans, facilitating family meetings, and addressing resident and family concerns.

Condition of Employment:
Candidate must successfully complete Pre-Employment Medical Clearance consisting of a Physical, PPD, Drug Test.