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Social Worker

Location:
Canton, MA
Company:
Hebrew SeniorLife

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The Orchard Cove Skilled Nursing Social Worker provides emotional support to residents and their families during crucial life transitions such as admission, discharge, transitions through Orchard Cove’s continuum of care and the dying process. The Social Worker shall advocate for the resident and his/her family on an individual basis and in a group setting in an effort to best support “What Matters Most” to each resident, in turn allowing the delivery of care and services to be aligned to those values and preferences. The Social Worker is part of an interdisciplinary Orchard Cove team that ensures that residents live in the right place, at the right time and receive the right care. The Social Worker will assist each resident in maintaining his/her highest practical level of physical, mental, and psycho-social wellbeing.

The Social Worker shall be responsible for bed management and census goals which includes coordinating the admissions process; assigning appropriate beds to patients/residents; organizing clinical data for distribution; completing all necessary admission paperwork; providing Medicare Notices of Non Coverage to prepare for status changes; and assisting patient/residents in securing appropriate home care services to ensure a proper discharge plan or move to a different level of care, as appropriate. S/He will also collaborate with colleagues to contribute to the rest of the continuum of care as needed.


  • Provides emotional support to residents and families during times of transition; adjustment to life in a nursing home; acceptance of change in medical condition and end of life
  • Completes all admission and discharge paperwork with resident/family
  • Serves as an advocate for a resident/family in individual and group settings
  • Key communicator between resident/family/staff
  • Manages census and payor mix goals
  • Coordinates admissions and discharges
  • Delivers all required notices including the Medicare Notice of Non-Coverage; the Advanced Beneficiary Notice; etc.
  • Completes discharge planning and ensures a safe discharge for all residents leaving the unit
  • Lead and document all baseline, annual and quarterly care conferences; review the chart, admission packet signatures, admission assessments, social histories, and confirm advanced directives.
  • Managed care patients - communicate with case managers and send updates as needed.
  • Care Management - work with the interdisciplinary team, patient, and family to plan safe discharge or move to different level of care.
  • Participate in care continuum meetings
  • Ensure compliance with preadmission screening and discharge notifications and referrals
  • Admission and Bed Utilization: Point person with Central HSL and work with the marketing team to leverage prospective residents request across the different service lines of HSL.

  • Bachelor’s degree in Clinical Social Work (Masters Preferred)
  • Licensed Independent Clinical Social Worker (LICSW)
  • Excellent communication skills
  • Trained mediator

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