Medical Social Worker Job Description

This position will provide appropriate medically related social services to each resident.

Social workers hired by North Star Manor will be qualified as defined by federal regulations (F251), by state regulations and/or state licensure laws. Because the definition of qualified social work often is not consistent between federal regulations, state regulations and state social work licensure laws, it is important that all three are taken into consideration when hiring a social worker.

The federal regulations outline a qualified social worker as an individual with:

  1. A bachelor’s degree in social work or a bachelor’s degree in a human services field including, but not limited to, sociology, special education, gerontology, rehabilitation counseling and psychology;


  1. One year of supervised social work experience in a healthcare setting working directly with individuals.

Individuals who meet the educational requirements defined in (1) above, but who lack the one year of supervised social work experience in a healthcare setting may be considered as potential employees. This may require the services of a social work consultant until the year of supervised social work experience is fulfilled. Some state regulations and/or state licensure laws are narrower in their definition of a qualified social worker and warrant review.

The social work director must be qualified, although these hiring requirements include all social workers whether they are department directors or secondary employees within the social work department if the scope of their job encompasses the professional practice of social work. The practice of social work involves having specialized knowledge of social resources, human capabilities and the roles that individual motivation and social influences play in determining behavior and involves the application of social work techniques including but not limited to:

  1. Counseling with individuals, families or groups.
  2. Providing information and referral services.
  3. Assessing (completing portions of the MDS, performing social assessments, etc.), explaining and interpreting the psychosocial needs of individuals, families and groups.
  4. Enhancing the problem-solving and coping capacity of people.
  5. Linking people with systems that provide them with resources, services and opportunities.
  6. Admission and discharge planning.
  7. Care plan coordinator.
  8. Providing alternatives to drug therapy or restraints.
  9. Behavior management coordinator.
  10. The ability to provide interventions to help the resident attain or maintain his or her highest practicable physical, mental and psychosocial well-being.

Through ongoing assessment, the location will provide related social services to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident. The facility will aggressively identify the need for medically related social services and pursue the provision of these services.

Medically related social services mean services provided by the facility’s social services personnel to assist residents in maintaining or improving their ability to manage their daily physical, mental and psychosocial needs. It is also the purpose of the medical social worker to ensure that residents and families have assistance with appropriate medically related social services.

The social worker is considered an integral part of the interdisciplinary team for the psychosocial care of the resident. Committees that the social worker is involved with include, but are not limited to, the following:

  1. Behavior management committee
  2. Reduction committee
  3. Quality assurance performance improvement (QAPI) committee
  4. Care conferences
  5. Admissions, Transfers and Discharge meetings

Additional social work interventions may include:

  1. Individual sessions with the resident
  2. Group sessions with residents
  3. Educational in-services for residents and families such as:
  4. Resident rights
  5. Abuse
  6. Grievances
  7. Advance directives
  8. Behavior management
  9. Training for staff members in psychosocial issuesThe social worker will be educated in treatment philosophies and modalities by attending in-services. The social worker also will be involved with other departments in planning programs and offerings for residents as part of the psychosocial milieu, such as the following:
  • Activities
  • Nursing
  • Administration
  • Environmental services
  • Dietary
  • Rehab or therapy

The social worker will provide medically related social services. “Medically-related social services” means services provided by the location’s staff members to assist residents in maintaining or improving their ability to manage their daily physical, mental and psychosocial needs. These services might include, for example:

  • Planning for obtaining needed adaptive equipment, clothing and personal items.
  • Maintaining contact with family (with resident’s permission) to report on changes in health, current goals, discharge planning and encouragement to participate in care planning.
  • Assisting staff members to inform residents and family (with the resident’s permission) about the resident’s health status, healthcare choices and ramifications.
  • Making referrals and obtaining services from outside entities (e.g., talking books, absentee ballots, community wheelchair transportation).
  • Assisting residents with financial and legal matters (e.g., applying for pensions, referrals to lawyers, referrals to funeral homes for pre-planning arrangements)
  • Discharge planning services (e.g. helping to place a resident on a waiting list of community congregate living, arranging intake for home care services for residents returning home assisting with transfer arrangements to other facilities).
  • Providing or arranging provision of needed counseling services.
  • Through the assessment and care planning process, identifying and seeking ways to support residents’ individuals needs and preferences, customary routines, concerns, and choices.
  • Building relationships between residents and staff members and detaching staff members how to understand and support residents ‘individual needs.
  • Promoting actions by staff members that maintain or enhance each resident’s dignity in full recognition of each resident’s individuality.
  • Assisting residents to determine how they would like to make decision about their healthcare and whether they would like anyone else to be involved in those decisions.
  • Providing alternatives to drug therapy or restraints by understanding and communicating to staff members why residents act as they do, what they are attempting to communicate and what needs the staff members must meet.
  • Meeting the needs of residents who are grieving.
  • Finding options that most meet their physical and emotional needs.
  • Meeting the needs of residents and families regarding end-of life issues.
  • Assisting residents and families to understand the disease process.
  • Ensuring that a resident who displays mental and psychosocial adjustment difficulty receives appropriate treatment and services to correct the problem.

The social worker needs to be aware of the factors with a potentially negative effect on physical, mental and psychosocial well-being include an unmet need for

  • Dental/denture care
  • Podiatric care
  • Eye care
  • Hearing services
  • Equipment for mobility or assistive eating devices
  • Need for homelike environment, control, dignity and privacy

When needed services are not covered by the Medicaid State Plan, nursing locations and the social worker still required to attempt to obtain these services. For example, if a resident requires transportation services that are not covered under a state Medicaid Plan, the nursing location and social worker are required to arrange these services. This could be achieved, for example, through obtaining volunteer assistance.

Types of conditions to which the location should respond with social services by staff or referral include:

  • Lack of an effective family or social support system
  • Behavioral symptoms
  • If a resident with dementia strikes out at another resident
  • Presence of a chronic disabling medical or psychological condition
  • Depression
  • Chronic or acute pain
  • Difficulty with personal interaction and socialization skills
  • Presence of legal or financial problems
  • Abuse of alcohol or other drugs
  • Inability to cope with loss of function.
  • Need for emotional support
  • Changes in family relationships, living arrangements and/or resident’s condition or functioning
  • A physical or chemical restraint

This position will report to the facility administrator or Director of nursing.

Salary requirements will depend on education and years of experience.

This position requires minimal lifting.

The social work position will be familiar with the Social Work Code of Ethics and be eligible for licensure in the State of Minnesota with no encumbrances against the social worker’s license.