Working as a Social Worker in Long-Term Care (LTC): A Complete Guide

When you think of a nursing home, what comes to mind? For many of us, we think of the residents. Typically, these are older adults who are no longer able to live independently due to physical or cognitive decline. You might also think about the direct care staff – these are the nursing assistants, medication aides, and nurses who provide the daily care to residents. But what about social workers? Social workers play a vital role in a nursing home’s care team while having a significant impact on resident outcomes and well-being.

What's it like to be a social worker in long-term care?
Social workers have one over-arching goal: to ensure that residents receive the highest quality of care while promoting and protecting rights, independence, and dignity for each individual resident. Social workers are involved in the admission process -- which often begins before a resident moves into a center – as well as coordinating resident care meetings with family members, conducting regular assessments and interventions, and serving as a trusted resource for residents and their family members.

When working in nursing homes or senior living settings, social workers can expect the following as part of their job duties:

• Work directly with residents, the care team, and family members to identify unique psychosocial, mental, and emotional needs
• Complete psychosocial assessments
• Develop and implement viable care plans, and provide 90-day treatment plan updates
• Attend care conferences and maintain the appropriate amount of continuing education
• Complete resident rounds with the doctor
• Work directly with other members of the residents' car team, such as hospice providers 
• Coordinate with insurance case managers
• Complete ancillary services (usually once a month or quarterly)
• Talk with families about complaints or reports of abuse/neglect
• Coordinate discharge planning and refer residents to appropriate services, such as home care or hospice

Is there a social worker in every nursing home?
The Centers for Medicare & Medicaid Services (CMS) only requires a full-time social worker on staff for nursing centers that have more than 120 beds.

Do I have the right type of license to be a social worker in a skilled nursing facility?
Depending on the building, social workers may be required to have a specific type of licensure or experience:

• Social Worker – A social worker is someone who graduated from an accredited program but is not licensed, otherwise referred to as “unlicensed social workers.”
• Licensed Social Worker (LSW) – LSWs have earned a bachelor’s or master’s degree in social work. In addition to their schooling, they must pass the LSW state exam.
• Licensed Independent Social Worker (LISW) – To become a LISW, individuals are required to have a master’s degree in social work from an accredited program, two years of experience as a Licensed Social Worker, and 150 hours of training supervision by a LISW-S. Proof of supervision completion must be submitted to the Board prior to applying to take the LISW exam.

Please note that licensure requirements vary by state. There is a Social Work Interstate Compact that allows social workers in certain states to obtain in a multistate license which authorizes practices in other compact states. To find out which of the 21 states have legislation enacted, view the Social Work Licensure Compact Map.

There are many career paths available for social workers, including interim or contract positions. If you’re thinking about dipping your toe into the travel social work world, take a look at our interim social work positions on our job board.