Acknowledge Your Social Worker: March Is Social Work Month!

This blog post was made by Beth Witten, MSW, ACSW, LSCSW on March 20, 2014.
Acknowledge Your Social Worker: March Is Social Work Month!

How much do you know about social workers and what they do? If you work in a dialysis or transplant setting, you probably know at least one social worker because Medicare regulations require these settings to have social workers. But, did you know...

  • Nephrology social workers must have a Master's degree in social work from a Council on Social Work Education accredited graduate program. The only exception is if the individual had at least 2 years of social work experience when hired to work in dialysis or transplant in 1975 and receives regular supervision from a qualified social worker.1
  • Nephrology social workers must meet the scope of practice board and licensure requirements in the state where they work.2
  • Social workers must practice within a Code of Ethics that is based on seven core values: service, social justice, dignity and worth of the person, the importance of human relationships, integrity, and competence, and requires the social worker to "not allow an employing organization's policies, procedures, regulations, or administrative orders to interfere with their ethical practice of social work."3
  • Social workers help the interdisciplinary team improve patient outcomes by:

  • Assessing patients' psychosocial status and needs: reviewing support systems, education, cognitive status, work history and vocational goals, financial status and concerns, understanding of the illness, knowledge of and interest in treatment options based on lifestyle, coping strategies, strengths and barriers related to following the treatment plan, need for resource referrals, and more...4
  • Offering the KDQOL-36 or other age appropriate physical and mental functioning survey to patients, explaining its relevance to them, reviewing results with them, and identifying goals and priorities—then providing psychosocial interventions to help patients and families cope with the life changes caused by kidney failure and dialysis and referring patients to local and national organizations as well as state and federal agencies that can help patients meet day-to-day needs.5
  • Collaborating with the interdisciplinary team—including the patient—to plan care that addresses the patient's needs and goals as well as goals of the clinic.6
  • Addressing situations that place a patient are at risk of involuntary transfer or involuntary discharge.7
  • Participating as a member of the Quality Assessment and Performance Improvement team and helping the team track and trend data such as facility-level scores on the physical and mental functioning survey, patients who were excluded, patients who refused to complete the survey; and patient satisfaction and grievances.8
  • The ESRD Conditions for Coverage places the responsibility on the clinic's governing body for providing sufficient staffing, including staffing of social workers, to meet patients' clinical needs. In fact, the regulations say that if social workers are shared with multiple clinics or have to perform non-clinical tasks, "it must not negatively impact the time available to provide the clinical interventions required to achieve the goals identified in the patient's plan of care."9

    Social workers want to be liked and seen as team players. Toward this end, they may take on any task they're assigned. However, when social workers take on clerical tasks like admissions paperwork, entering data in CROWNWeb, or finding help to pay for drugs or dialysis chairs and scales the clinic is required to provide, these take time away from their mandated responsibility to provide clinical services to enhance patient's well-being. Understand that when social workers set boundaries on clerical tasks, there are limits to available time and the scope of their license.

    Finally, recognize that paying Master's prepared social workers to do clerical work when they should be helping patients achieve their plan of care goals and helping the clinic meet QIP performance measures is just plain penny wise and pound foolish!


    1. 42 CFR 494.140(d), Condition: Personnel qualifications, Standard: Social worker
    2. 42 CFR 494.140, Condition: Personnel qualifications
    3. Code of Ethics, National Association of Social Workers at
    4. 42 CFR 494.80(a)(7), Condition: Patient assessment, Evaluation of psychosocial needs by a social worker
    5. 42 CFR 494.90(a)(6), Condition: Patient plan of care, Psychosocial status
    6. 42 CFR 494.80, Condition: Patient assessment
    7. 42 CFR 494.180(f), Condition: Governance, Standard: Involuntary discharge and transfer policies
    8. 42 CFR 494.110, Condition: Quality assessment and performance improvement
    9. 42 CFR 494.180(b), Condition: Governance, Standard: Adequate number of qualified and trained staff


    • William Brown

      Dec 10, 2014 4:58 AM

      Master Social Worker at my Dialysis Clinic, Inc. retired in April, 2014. She has not been replaced. A social worker is trying to fill-in for several DCI facilities as they refuse to hire a social worker for each clinic as was the case earlier this year. Our social worker office has been converted to a conference room.

      I have never received counseling regarding the proposed involuntary discharge presented to me on 04 Dec 2014. I have only 30 days to find my own facility from a list provided with the discharge notice. I was informed that it will be my duty to find a new clinic. Of course I will be black-balled from all area facilities because the nephrologists from my area all belong to Nephrology Associates and stick together.

      I have filed numerous complaints, grievances and claims with the Tennessee Board of Nursing, that is the real reason I am being discharged. My complaints are all justified, but be warned that any complaining instantly becomes "uncooperative" and "disruptive", both reasons for discharge.

      If anyone can help me find an attorney in the Chattanooga TN area, please send me an email at:
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