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Division of Nephrology and Hypertension

Receiving the diagnosis of an illness can be a confusing time for anyone. Will I be able to handle the treatment? How will I balance my care with the needs of my family? How will this affect my job? Who will help me figure all this out?

As an integral member of the interdisciplinary team, more than 110,000 health care social workers across the country act as the advocate for a client’s needs and guide them in making decisions about their physical and emotional care. Clinical social workers also work with the family to understand and to help the client through counseling or support groups. Macro social workers help conduct research, provide community outreach, and advocate for policy changes that enhance the well-being of patients and providers.

Guidelines for Nephrology Social Workers (NASW/NKF)

Nephrology social work services support and maximize the psychosocial functioning and adjustment of patients who are experiencing end-stage renal disease (ESRD) and their families. These services are provided to ameliorate social and emotional stresses resulting from the interacting physical, social, and psychological concomitants of ESRD, including shortened life expectancy; altered lifestyle with changes in social, financial, vocational, and sexual functioning; and the demands of a rigorous, time-consuming, and complex treatment regimen. Social work functions as a part of the multidisciplinary team and is responsible for fostering a positive treatment environment policy and routines that are attuned to cultural, religious, and ethnic differences among patients and families and show respect for the individuality, independence, and choice of each patient.

Major Functions and Services Provided

  • Psychosocial evaluation (assessment for treatment plan)
  • Casework (counseling and conferences with patients, families, and support networks; crisis intervention; goal-directed counseling; discharge planning)
  • Groupwork (education, emotional support, self-help)
  • Information and referral
  • Facilitation of community agency referrals
  • Team care planning and collaboration
  • Advocacy on patients’ behalf within the setting and with appropriate local, state, and federal agencies and programs and programming
  • Patient and family education

Major Categories of Problems Addressed

  • Adjustment to chronic illness and treatment as they relate to quality of life
  • Physical, sexual, and emotional relationship problems
  • Educational, vocational, and activity of daily living problems
  • Crisis and chronic problem solving
  • Problems related to treatment options and setting transfers
  • Resource needs, including finances, living arrangements, transportation, and legal issues
  • Decision making regarding advance directives

CMS Conditions of Coverage for Suppliers of ESRD Services

§ 494.140 Condition: Personnel qualifications.

(d) Standard: Social worker. The facility must have a social worker who—

(1) Holds a master’s degree in social work with a specialization in clinical practice from a school of social work accredited by the Council on Social Work Education; or

(2) Has served at least 2 years as a social worker, 1 year of which was in a dialysis unit or transplantation program prior to September 1, 1976, and has established a consultative relationship with a social worker who qualifies under § 494.140(d)(1).

View the complete Conditions of Coverage, which further outlines the social workers role in ESRD patient care.

View a listing of ESRD conditions of coverage with psychosocial relevance.

Council of Nephrology Social Workers of the National Kidney Foundation (CNSW)

The Council of Nephrology Social Workers (CNSW) functions as a professional membership council within the framework of the National Kidney Foundation (NKF) and networks with other organizations, including the Health Care Financing Administration (HCFA), state and local governments, and private groups. CNSW’s purpose is twofold: one, to assist patients and their families in dealing with the psychosocial stresses and lifestyle readjustments and facilitate a treatment program that will maximize rehabilitation potential; two, to support the federal regulations governing ESRD reimbursement in regard to standards for social work practice and in the definition of a qualified social worker.