Foreword   Mercedes Bern-Klug, PhD, MSW, MA

xi

Preface

xiii

Acknowledgments

xix

PART I

SOCIAL WORK IN NURSING FACILITIES

1

The Changing Face of Nursing Home Social Work

1

2

Basic Orientation

9

3

Charts and Documentation

25

4

Assessment and the Plan of Care

41

PART II

THE INTERDISCIPLINARY TEAM

5

The Interdisciplinary Meeting

49

6

Room Changes

55

7

Facility Staff Training and In-Services

63

8

Social Work Consultation in the Nursing Facility

71

PART III

NURSING FACILITIES AND GOVERNING OVERSIGHTS

9

Screenings for Long-Term Care

77

10

Preadmission and Admission to Nursing Facilities

85

11

OBRA—The Omnibus Budget Reconciliation Act

93

12

Legal Auspices of Social Work

101

13

The Minimum Data Set and the Social Worker

109

14

Long-Term Care Ombudsman Program

127

15

State Surveys and JCAHO Surveys

133

16

Policies in the Nursing Facility

143

PART IV

DIAGNOSIS, TREATMENT, AND CARE ISSUES

17

Dementia

147

18

Depression

155

19

Medication and Antipsychotic Medication

163

20

Pain in Older Adults

171

21

Sexuality

177

22

Mental Health Consultants

185

23

Groups in Nursing Facilities

193

24

Families and Next of Kin

201

25

Diversity, Culture, Ethnicity, and Long-Term Care Facilities

207

26

Spirituality and Religious Observance

215

PART V

ETHICS

27

Social Work Ethics

221

28

Legal Representatives

231

29

Abuse, Neglect, and Mistreatment

243

30

Confidentiality

253

PART VI

COMMUNITY LIAISONS

31

Resident Finances in the Nursing Home

261

32

Transfer and Discharge

271

33

Community Services

287

34

Funeral Arrangements

297

35

Disaster Planning

303

36

Troubles in Paradise

311

Appendix

Standardized Forms

319

Social Service Job Description Sample

319

Initial Social Service History and Assessment Form

322

Social Service History Initial Assessment

323

Quarterly Social Service Note Form

326

Social Service Quarterly Progress Note

327

Social Service Evaluation Form

328

Social Service Evaluation

329

Interdisciplinary Team Meeting Record

333

Preadmission Screening Scenario

335

Identification Screening for Nonrecipients Waiving LTC Screening (Massachusetts Example)

336

Notices for Transfer or Discharge

338

Example of 30-Day Notice of Intent to Transfer/Discharge Resident

339

Example of Notice of Nursing Facility Resident’s Rights Regarding a Transfer/Discharge

340

Example of a Request for a Hearing

341

Example of Notice of Intent to Transfer or Discharge Resident With Expedited Appeal

342

Bed-Hold Form

344

Bed-Hold Policy and Notice (Massachusetts Sample)

345

Community Discharge Plan Form

347

Community Discharge Plan

348

Nursing Home Social Work Practice Standards: An Example From Massachusetts

349

Health Care Proxy Form (Massachusetts and New York)

360

Massachusetts Health Care Proxy

360

New York State Health Care Proxy

362

HIPAA Policy Example

364

Online Resources

367

Glossary of Commonly Used Terms and Abbreviations

379

Index

383