SOCIAL WORKER

Overview :

Ebenezer is looking for a S ocial Worker to join our team! This role is responsible To support and advocate for residents in coping with the psychosocial aspects of their lives including grief, loss, and change.

To coordinate transitions including room changes, discharge plans and end of life preferences at our Skilled Nursing Facility in Bloomington, MN.

Great experience and opportunity for further growth within the organization!

Martin Luther Care Center , part of the Martin Luther Senior Living Campus is located in East Bloomington, near woodlands / wetlands and along the Minnesota River Bluffs.

Managed by Ebenezer, we offer 137 units between our Skilled Nursing, Memory Care and Transitional Care. We have an outstanding team of tenured staff.

The only thing missing is YOU! Martin Luther Care Center was named Top Nursing Home and Transitional Care Center by US News and World Reports the past two years.

Amazing Benefits!

Paid Time Off, Retirement monies, tuition reimbursement, scholarships, Medical / Dental / Vision, Wellness stipend, Cash Out Wages Before Payday with our New Benefit of Early Wage Access!) https : / / www.

ebenezercares.org / employee-benefits

Ebenezer is proud to be voted 2024 Star Tribune Top Work Place , and has received this honor fifteen years in a row. We're an established organization with over 100 years of excellent service and an outstanding rate of growth.

When you come to work at an Ebenezer community, we strive to support your growth, honor your strengths and empower you to make a difference in the lives of others.

Responsibilities / Job Description :

• Completes psychosocial assessment, BIMS and PHQ interviews Invites res, representatives, and other community identified partners to care conference;
• facilitates care conference process Assesses psychosocial changes and works with resident, families, house psych and care team to determine appropriate interventions Maintains departmental records, documents as required, updates PCC contacts as appropriate Completes MDS and associated assessments per regulations Develops care plans for resident cognition, psychosocial / mood, behavior, and discharge plan Assists resident and residents representative in changing primary care providers as appropriate Advocates for residents rights and needs Assists with Advance Care planning conversations and documentation;
• sends advance directives and other appropriate documents to Honoring Choices for review and validation as appropriate; uploads into PCC and informs care team of needs Assists with investigation and follow up on grievances 1 : 1 support of residents Assists res and families with completion of MA application as appropriate Makes referrals to designated county for EW, CADI and PCA assessments Develops behavior plans / safety agreements in consultation with house psychology services and care team Coordinate hospice referrals with hospice and care team;
• and works with nursing dept to ensure that designated hospice care plan / book is current and up to date Coordinates house psychology and psychiatry referrals on behalf of res;

works with care team to capture and follow up on any care plan recommendations

Provides pre-admission counseling and tours Facilitates the intake process with appropriate community and / or hospital provider Verifies payer source for admission through appropriate portal and / or entity Facilitates PAS screening and Level II as needed Coordinates admission process with resident, resident representative, and community providers as appropriate Completes admission paperwork Informs residents of financial responsibilities, payment options and agency contacts according to the federal regulations Builds and maintains relationships with referral sources;

and assists with marketing and outreach as appropriate. Coordinates room change process as appropriate Assists with development of Shared agreements and works with care center team to problem solve barriers and address res needs when payer source does not exist

Serves as Resident Advocate and Facility Liaison for Family Council as appropriate

Facilitates necessary discharge planning and coordination

Assists in Vulnerable Adult investigations and completes necessary documentation and reports

Qualifications : Required

Required

Bachelor's Degree : List BSW (from an accredited school of social work)

Licensed by the State of Minnesota Board of Social Work

0 to 1 year of experience

Preferred

1 to 3 years of experience

Two years experience in LTC or TCU

Experience in Medical Social Work