Provides appropriate referrals and manages coordination of patient appointments; per Plan of Care Crisis Intervention, Psychosocial Assessment/Functioning, Counseling Support & Referral, Abuse/Neglect Identification & Referral (Partner, Child, Elder), Family Issues Affecting Care, Coping/Emotional Adjustment, Grief/Bereavement Support (Individual & Group), Adoption Resources, Health/Wellness Promotion, Substance Abuse Screening/Resources, Psychiatric Screening/Behavior, Management, Staff Support and Crisis Intervention (Critical Incident Stress Debriefing). The functions of the Social Worker includes crisis intervention, patient /family intervention, high risk screening, counseling, referring for financial or other identified resource needs, arrange and facilitate family/patient representative meetings with the health care team as needed, assist in post acute placement on complex discharges and.