Essential Functions:
Participates in the development and maintenance of treatment plans.

Evaluates and develops in collaboration with physician and other care team members, a Plan of Care to address/ treat psychosocial and emotional status to meet the patients needs.Completes patient's case assessments, prepares clinical and progress notes and participates in case conference as required.Involves patients and family members in developing and implementing the plan of care whenever possible.Instructs other team members, patients, and families in understanding the social and emotional factors related to the health problems of the patient.Instructs patients and families of correct utilization of appropriate community resources as needed.Acts as a consultant to home health care interdisciplinary team members as needed.
Implements current medical social work practice.

Maintains comprehensive listings of all community services available to home care patients and their families.Helps patients and families to understand, accept, and follow medical recommendations and provides services planned to maximize individual capabilities.Helps patients and families with personal and environmental difficulties that predispose illness or interfere with obtaining maximum benefits from medical care.Engages in resource planning by making arrangements with other supportive services for which the patient is eligible.Participates in discharge planning activities and prepares appropriate documentation.Implements appropriate infection control and safety measures and reports all hazards and accidents in a timely and accurate manner.Maintains confidentiality of patient information.
Participates in professional growth and development.

Attends Agency in-services as required.Develops and presents educational programs for Agency clinical staff as required.Remains active in appropriate professional and community organizations to enhance knowledge of resources available to patients and their families.Participates in Performance Improvement programs.
Fulfills additional performance responsibilities as assigned and as necessary.