Exploring the Roles of Social Workers in SNFs

It is National Social Worker Month and is the perfect opportunity to look at the impact social services and social workers have on Skilled Nursing Facilities (SNFs), or nursing homes residents and families.

But first, we will look at the emergence of social workers and how they became the voice for the voiceless throughout the profession’s history.

Short History of Social Workers:
The first social work class was offered in the summer of 1898 at Columbia University. The profession was originally established to ensure immigrants and other vulnerable people could escape economic and social poverty. Social workers have led the way and spoke out against abuse and advocated for a variety of populations facing adverse conditions. Those populations included civil rights, workers, individuals with mental illness, children, those with substance abuse and seniors.

Social Workers Roles in SNFs:
Social workers and those in social services have a variety of roles in SNFs, but their primary role is to serve as a bridge into the facility and be the voice for the resident and family. This role can be broken down into several stages that includes work done before a resident’s admission throughout their stay, and discharge.

This blog will briefly look at the different duties a social worker may perform at a SNF.

Many times, the social worker is the person at a SNF to contact with questions regarding admission. Some centers have a Marketing/Admissions Coordinator that may also serve this purpose, but the social worker is a great resource to begin the journey.

This is often called pre-admission. Potential residents and families can talk with the center about amenities, services, activities, dietary, rehabilitation, and other information about the center. Social workers can give a tour of the center and it is highly recommended potential residents and families tour the location they interested in receiving care. This also allows the resident or family to ask additional questions and get a sense of what the center can offer.

Once the resident and family has decided on a center to provide care, the admission process begins. A social worker may help a family by getting all the information they can about the resident’s preferences, needs, care requirements, financial information, and payor resources.

Upon entering the center, the social worker, along with other appropriate employees, can help the resident and family with an orientation process. This also provides an opportunity for all parties to ask questions about this transition period. This can be a stressful time for residents and families, and it is the role of the social worker in a SNF to help make this transition as smooth as possible.

The Plan of Care:
After the resident has moved into the center the social worker will work with the other departments to help create a holistic and comprehensive plan of care to meet the resident’s needs. The social worker will consider the clinical needs as well as the culture, religious preferences, cognitive impairments, special needs, and personal preferences of the individual.

The resident, if cognitively possible, and the family are encouraged to participate in creating the plan of care, so the resident or family has some control in their new schedules and care.

The social worker will conduct assessments on residents to properly place them and document their needs and progress. Physical, emotional, and social needs are all factored into a plan of care.

Throughout a resident’s stay at a SNF the social worker will conduct regular assessments of the care plan to ensure it is being effective and doesn’t require modifications.

Modifications to the plan of care should happen with the resident and family present. This provides the resident with a feeling of independence and allows the family to express any concerns. It is the responsibility of the social worker to intervene to solve problems and resolve any complaints. Social Workers will also be aware of services for issues including abuse, neglect, financial exploitation, and financial assistance.

If anyone in a SNF expresses concern to a family member or friend on the outside, that person should immediately call the facility’s social worker about the issue.

The social worker is an important member of a SNF, and if nursing home care is a consideration for your family, contact the social worker at each place of interest. They will help make a potentially stressful situation as uncomplicated as possible.

To learn more about the social work profession, visit the National Association of Social Worker’s website.

Author: Brandon S. Totten
Digital Media Coordinator, Kissito Healthcare