The Social Worker, in partnership with physicians, nursing, and healthcare team members, utilize professional medical social work skills to assess resident and family needs while residing at the skilled nursing facility. Assessment, planning intervening and reassessment are performed in a collaborative environment. The Social Worker serves the Skilled Nursing Facility and includes proactive, individualized planning for patients' progress across the continuum that optimizes quality of care and resident satisfaction. The Social Worker will participate collaboratively to assist residents with any discharge planning needs.
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