Medical social work
Medical social work is the part of home health that deals with everything surrounding the illness — the money, the paperwork, the family strain, and the question of what happens when skilled care ends. It is ordered as part of the plan of care when the clinical team identifies a need for it.
What a medical social worker helps with
- Benefits and coverage. Working out what you are entitled to and helping you apply — including MO HealthNet, and including the Consumer Directed Services program if long-term personal care is the real need.
- Community resources. Meal programs, transportation, durable medical equipment, utility assistance, caregiver support.
- Adjustment and coping. Serious illness reorganizes a household. So does becoming dependent on people who used to depend on you.
- Family and caregiver strain. Including the conversations families find hardest to start.
- Planning ahead. Advance directives, and honest discussion of what happens if things do not improve.
- Safety concerns. Including suspected abuse, neglect or exploitation.
The transition problem
The most useful thing a medical social worker does in this agency is handle the moment the skilled episode ends. Home health is designed to stop. What is left is often a person who still needs help every day with bathing, meals and getting around — a need no clinical benefit covers.
Because Communicare Elite also operates an enrolled MO HealthNet Consumer Directed Services vendor, that conversation can happen before discharge rather than after a crisis. If CDS is the right fit, we can explain it and start the process. If it is not, the social worker can point you at what is. CDS eligibility →
Reporting concerns
Medical social workers are mandated to act on suspected abuse, neglect or exploitation. If you are worried about someone, you do not need to wait for a professional — the Missouri Adult Abuse and Neglect Hotline is 1-800-392-0210, 24 hours a day. More on reporting →
Who provides the care
Communicare Elite coordinates the whole plan. Some visits are delivered by our own staff; others are arranged through partner providers we work with regularly. Either way one agency is accountable for the plan of care, and you have one number to call rather than four.
Need skilled care at home?
Call (314) 809-6655, or text (314) 886-5902. Home health starts with an order from your physician — we can talk you through how to get one.