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Social Services Coordinator - LTC in Fairbury, Nebraska at Jefferson Community Health Center

Jefferson Community Health Center
Fairbury, Nebraska, 68352, United States
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Job Description

Jefferson Community Health & Life is looking to hire a Social Services Coordinator in Gardenside, LTC.

Full-time -36 - 40 hours per week. Main hours will be 7:30am - 4:00pm. Hours may vary based on the needs of the residents.

Mainly Monday through Friday. Some weekends and holidays may be assigned as needed.

POSITION SUMMARY:

Identifies personal and medically related social service needs of the resident and assures that the individual needs are met by coordinating services with appropriate disciplines. Makes appointments and provides transportation to meet the medical and personal needs of the resident. Documents assessments, care plans and social service interventions per facility policy as appropriate.

QUALIFICATIONS:

  • Qualified Social Worker Preferred. MSW or BA with 1 year experience or Associates degree with 1 year experience or degree in social/behavioral science with 1 yr experience OR successfully completed 24 hour social services designee training approved by the state of Nebraska.
  • Heart Saver CPR Certification
  • Attend 36 hours of training with DHHS to obtain Social Services Designee training to care for residents in LTC setting
  • Must have and maintain current driver’s license to drive with acceptable driving record per facility standards
  • SHIPP training, preferred.
  • Must have current CNA certification or must obtain within 9 months of employment

JOB DUTIES AND RESPONSIBILITIES

Coordinates all social service functions with other social service, activity and nursing staff;

  • Remains current on all State and Federal regulations pertaining to the provision of social services in long term care
  • Attends trainings pertaining to statutory regulations
  • Utilizes professional resources as needed to meet regulatory guidelines.
  • Develops and updates polices/protocols and documents to guide the provision of social services for LTC residents, including but not limited to admission agreement, Medicare notices, advanced directives, etc. Applying for pension.

Assists residents with financial and legal matters;

  • Referrals to lawyers
  • Referrals to funeral homes for preplanning arrangements
  • Assisting with Medicare and Social Security applications/decisions
  • Application and renewal for financial assistance programs

Coordinates admission process;

  • Acts as the initial contact point for potential new admissions
  • Coordinates collection of information for Interdisciplinary Team to make determination for admission
  • Assisting residents & family members with the admissions process, including signing of admission agreement
  • Coordinates collection of copies of advanced directives, including POA’s, & guardianships

Coordinates medical appointments and transportation for Gardenside residents, including but not limited to;

  • Eye care
  • Dental care
  • Counseling services

Makes referrals and obtains services from outside entities, including but not limited to;

  • Absentee ballots
  • Transportation needs
  • Dental/denture care
  • Eye care
  • Hearing services
  • Other health services as needed

Decides to obtain needed adaptive equipment, clothing and personal items

Performs and documents all assessments necessary to accurately complete the appropriate sections of the MDS and develop an individualized psychosocial plan of care.

  • Elicits input from resident, family and all care staff to complete MDS assessment and care plan.
  • Develops monitors & implements individualized resident plan of care to meet the psychosocial needs of each resident.
  • Monitors effectiveness of plan of care and make modifications as necessary.
  • Initiates new assessment period as change in condition dictates.
  • Participates in complete care plan process and conference.
  • Recognizes significant changes in resident condition and notifies licensed nursing staff in timely manner.

Performs discharge planning services;

  • Helps to place a resident on a waiting list for community living
  • Decides for home care services for residents returning home
  • Assists with transfer arrangements to other facilities

Serves as a resident advocate to find options that most meet the physical and emotional needs of each resident

  • Provides or arranges provision of counseling services.
  • Assists residents in determining how they would like to make decisions about their health care, and whether they would like anyone else to be involved in those decisions
  • Responds to call lights and resident needs in a timely fashion.
  • Follows all aspects of the Eden Philosophy to provide care
Maintains records for animal care at Gardenside

Participates as an effective member of the Care Team.

  • Responds to Resident/Family concerns and provides immediate interventions when possible.
  • Reports concerns to appropriate personnel and provides written communication of concerns to necessary departments for appropriate follow-up as needed.
  • Adapts to changes in workload and completes assignments while maintaining quality care.
  • Initiates and performs duties which need to be completed although not directly assigned.
  • Promotes actions by staff that maintains or enhance each resident’s dignity in full recognition of each resident’s individuality.
  • Promotes team work through effective interpersonal relationships.
  • Demonstrates initiative and flexibility in provision of care.
  • Trains and coordinates Social Service Assistant in performance of essential job functions in the absence of the Social Service Coordinator.
  • Serves as a resource and role model for co-workers.
  • Holds co-workers to facility standards.

Provides and supports activities that insure and promote Resident Safety

  • Demonstrates proficient technical/clinical skills and operational knowledge of equipment within the Nursing Home, including any vehicles used for transportation purposes.
  • Reports variation in resident condition, staff conduct, equipment malfunctions or work conditions that may compromise safe, efficient resident care, to appropriate personnel.
  • Maintains clean work environment free of clutter to prevent injury.

Communicates effectively.

  • Communicates effectively with co-workers regarding resident conditions & psychosocial care needs, and changes in plan of care.
    • Resident needs with nursing staff
    • Care plan team
    • Other departments as necessary
  • Assists staff in informing residents and those they designate about the resident’s health status and health care choices and their ramifications.
  • Maintains contact with family (with resident’s permission) to report on changes in health, current goals, discharge planning and encouragement to participate in care planning process.
  • Informs supervisor regarding resident care/quality of life issues.

Performs and maintains documentation in a compliant, accurate, and timely manner.

  • Documents resident concerns and needs in medical record, as well as interventions, as care planned and resident’s response to those interventions, accurately.
  • Follows facility policy and procedures of documentation (approved abbreviations and corrections made in medical record).
  • Documents resident assessment for appropriate sections of the MDS Assessment within the time frames established by state and federal regulations.
  • Develops an individualized plan of care for each resident per approved standards.
  • Updates the plan of care and communication tools associated, in a timely fashion as needed.
  • Documents variances in care as needed and in a timely fashion.
  • Quality variance reports
  • Injury of Unknown Origin reports
  • Fall reports
  • Abuse reporting

See attached Job Description for full job duties.

Job Location

Fairbury, Nebraska, 68352, United States

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