Module: The Role of the Social Service Designee in Long-Term Care

In long-term care facilities, the Social Service Designee (SSD) plays a vital role in supporting the emotional, social, and psychosocial well-being of residents. Acting as a bridge between residents, families, and the interdisciplinary team, the SSD ensures that residents’ rights are upheld and that care plans reflect person-centered values.

Understanding the Role

The Social Service Designee is typically responsible for admissions coordination, psychosocial assessments, participation in care planning, managing discharges and transfers, maintaining resident rights, and ensuring compliance with federal and state regulations, including those outlined by CMS (Centers for Medicare & Medicaid Services). This role is essential in maintaining the dignity, individuality, and quality of life for each resident.

MDS and Care Planning

The Minimum Data Set (MDS) is a federally mandated assessment tool used in long-term care to collect standardized information about a resident’s physical, psychological, and social functioning. The SSD is involved in:

Completing the psychosocial sections of the MDS (Section D - Mood, Section E - Behavior, Section F - Preferences, etc.)
Conducting social histories and assessments to identify needs and preferences
Collaborating in the interdisciplinary care team to develop and revise comprehensive care plans
Ensuring that psychosocial concerns are accurately reflected and addressed in the care plan

Code of Ethics

Social Service Designees should abide by the National Association of Social Workers (NASW) Code of Ethics, which outlines key values such as service, dignity and worth of the person, importance of human relationships, integrity, and competence. In Kansas, while SSDs are not licensed social workers, they are still expected to uphold ethical standards including:

Maintaining confidentiality of resident information
Advocating for resident rights and dignity
Promoting autonomy and informed decision-making
Acting without discrimination

Medicare vs. Medicaid

Understanding the distinction between Medicare and Medicaid is essential in the SSD role:

Medicare is a federal health insurance program primarily for people 65 and older, or those with certain disabilities. It often covers short-term skilled nursing care following hospitalization, but does not cover long-term custodial care.
Medicaid is a joint federal and state program that helps cover long-term care services for low-income individuals. In Kansas, residents must meet income and asset guidelines to qualify. Medicaid is the main payer for long-term nursing home care.

The SSD helps families navigate applications, renewals, and transitions between payer sources.

The Role of Social Work Staff

In facilities that employ licensed social workers, the SSD may work alongside or under the supervision of a Licensed Master Social Worker (LMSW) or Licensed Specialist Clinical Social Worker (LSCSW). The responsibilities of the social services staff include:

Providing counseling and support to residents and families
Managing behavioral and mental health concerns
Facilitating care conferences and discharge planning
Ensuring proper documentation and regulatory compliance

Conducting Care Assessments

Social service assessments are a foundation for individualized care. A thorough assessment includes:

Resident history and background
Cultural and spiritual preferences
Family dynamics and support systems
Mental and emotional status
Social strengths and areas of concern

These assessments are updated periodically and during significant changes in the resident’s condition.

Kansas Consumer Handbook for LTC Facilities

The Kansas Consumer Handbook is a critical tool for informing residents and their families about rights and services in long-term care. It includes information about:

Resident rights
Facility responsibilities
How to file a complaint
Choosing a facility

View the Kansas Consumer Handbook (PDF)

Resident Council

The Resident Council is a key feature in promoting resident voice and autonomy. The SSD often serves as a liaison to the council, helping to:

Schedule and facilitate regular meetings
Document and respond to resident concerns
Ensure resident input is considered in decision-making
Encourage participation and empowerment

Resident Council minutes should be documented, concerns addressed promptly, and results shared transparently.

Additional Online Resources

As a Social Service Designee in Kansas, your role is central to ensuring residents receive holistic, respectful, and ethical care in long-term care environments. By advocating for residents, coordinating care, and upholding regulations, you help improve lives every day.

The Social Service Designee and LTC