RPM for Skilled Nursing
Remote Patient Monitoring for Skilled Nursing — Powered by athenahealth + CCN Health
Purpose-built RPM for Skilled Nursing communities. CCN Health integrates directly with athenahealth to automate clinical workflows and capture every eligible reimbursement.
CCN Health provides a certified Remote Patient Monitoring (RPM) integration with athenahealth designed specifically for skilled nursing facilities. The platform automates clinical documentation, enables real-time monitoring, and generates Medicare billing records for compliant reimbursement.
Remote Patient Monitoring for Skilled Nursing with athenahealth
For skilled nursing organizations using athenahealth, Remote Patient Monitoring creates a powerful combination of clinical oversight and operational efficiency. CCN Health's integration handles the technical complexity so your clinical team can focus on resident care.
Skilled Nursing Challenges That RPM Addresses
- Managing high-acuity patients with multiple comorbidities
- Reducing 30-day hospital readmission rates
- Meeting CMS quality measures and star ratings
- Maintaining survey readiness with comprehensive documentation
How It Works in Skilled Nursing
- Device Assignment — FDA-cleared devices (blood pressure cuffs, scales, pulse oximeters, or sensorless monitors) are assigned to the patient
- Automatic Data Capture — Vitals transmit via cellular gateway to the CCN Health platform without manual entry
- athenahealth Integration — Data flows directly into athenahealth patient records via cloud-based api
- Clinical Alerts — Abnormal readings trigger real-time notifications to care staff within 2 minutes
- Billing Automation — CPT codes 99453, 99454, 99457, 99458 documented automatically for compliant billing
Why Skilled Nursing Facilities Choose CCN Health
Readmission Prevention
Continuous monitoring during the critical post-acute window reduces hospital readmissions and improves quality scores.
Quality Measures
Objective vital sign data supports CMS quality reporting and star rating improvement efforts.
Survey Readiness
Comprehensive, timestamped records provide audit-ready documentation for state and federal surveys.
Acute-Level Monitoring
Continuous vital sign capture supports the higher-acuity clinical needs of skilled nursing residents.
Devices for Skilled Nursing RPM
| Device | Use Case | Resident Experience |
|---|---|---|
| Blood Pressure Monitor | Hypertension, heart disease | Automated cuff — press one button, reading transmits automatically |
| Weight Scale | Heart failure, nutrition monitoring | Step on scale daily, no buttons required |
| Pulse Oximeter | COPD, respiratory conditions | Finger clip for 30 seconds, automatic transmission |
| Dexcom G7 CGM | Diabetes management | Small sensor on arm, continuous readings without fingersticks |
| Xandar Kardian Sensor | General wellness, fall risk, sleep | Wall-mounted radar — completely contactless |
Clinical Benefits for Skilled Nursing
Chronic Disease Management
Monitor residents with conditions like post-surgical recovery, heart failure, pneumonia, COPD exacerbation. Trending data helps clinical teams adjust care plans before conditions deteriorate.
Transition of Care Support
When residents return from hospital stays, RPM enables closer monitoring during the critical post-discharge period.
Billing & Reimbursement in Skilled Nursing
CCN Health automates Medicare RPM billing documentation for qualified residents:
| CPT Code | Reimbursement | Requirements |
|---|---|---|
| 99453 | ~$19 | One-time device setup and patient education |
| 99454 | ~$50/mo | 16+ days of readings per 30-day period |
| 99457 | ~$48/mo | First 20 minutes of clinical monitoring time |
| 99458 | ~$38/mo | Each additional 20 minutes of clinical time |
Monthly potential per resident: $120+
Frequently Asked Questions
Does CCN Health integrate with athenahealth for skilled nursing RPM?
Yes. CCN Health's certified athenahealth integration enables bi-directional data flow specifically designed for skilled nursing workflows.
What is the implementation timeline for skilled nursing?
Most skilled nursing facilities are fully operational within 4 weeks, including integration setup, nursing staff training, and device deployment.
How does RPM billing work in skilled nursing?
CCN Health automatically documents the required data for 99453, 99454, 99457, 99458. Time tracking and transmission records are captured for audit-ready Medicare billing.
Implementation for Skilled Nursing
| Week | Activity |
|---|---|
| 1 | Discovery call and athenahealth configuration review |
| 2 | Technical integration setup and testing |
| 3 | Nursing staff training and device deployment |
| 4 | Pilot launch with select residents |
| 5+ | Full facility rollout and optimization |
Discovery call — we learn your workflows, EHR setup, and resident population.
CCN's AI engine configures optimal alert thresholds and EHR data mapping around your facility's patterns.
Go live with AI-powered monitoring, automated documentation, and billing — your team stays focused on care.
No one-size-fits-all templates. Every integration is configured for how your Skilled Nursing actually operates.
Book a Discovery CallAI-Powered Alerts
Pattern recognition catches changes early
Smart Workflows
Automated routing and documentation
Automated Compliance
Real-time audit trail and billing validation
Advanced intelligence working behind the scenes — faster processing, smarter alerts, effortless documentation.
Technology that stays in the background — so care stays in the foreground.
Why CCN Health
Why Skilled Nursing Facilities Choose CCN Health
Purpose-built technology that fits your clinical workflows and drives measurable outcomes.
Seamless EHR Integration
How CCN Health Works Inside athenahealth
Your monitoring data flows directly into athenahealth — no exports, no manual entry, no disruption to your clinical workflow.
RPM Devices
CGM, Scales, BP, SpO2
AI-Powered Platform
Intelligent data routing, anomaly detection, and automated documentation — working behind the scenes.
athenahealth
Charts & Care Plans
What Flows Between Systems
Patient Demographics
Conditions, medications, and census sync from your EHR
Vital Observations
Device readings flow automatically into patient charts
Discharge & ADT Events
Admission and discharge events trigger protocol changes
Care Plans
Treatment plans inform monitoring thresholds and alerts
Billing Documentation
CPT-ready records generated for claims submission
Cross-Program Data
RPM data available for CCM, PCM, BHI — no re-entry
“Every reading, every alert, every care plan update — available across all your programs. One integration, unlimited use cases.”
Infrastructure
Devices & Billing
FDA-cleared devices and automated Medicare billing — configured per resident, synced with the EHR.
Supported Devices
The Xandar Kardian sensor captures heart rate, respiratory rate, and room presence using radar technology — residents don't wear, charge, or interact with anything.
Medicare Billing
Remote Patient Monitoring (RPM)
4 billing codes
Initial setup and patient education on monitoring equipment
~$19
One-time
Device supply with daily recording or programmed alert transmission
~$50
Monthly
First 20 minutes of clinical staff time for RPM treatment management
~$50
Monthly
Each additional 20 minutes of RPM treatment management
~$40
Monthly (additional)
Common Questions
Frequently Asked Questions
Everything you need to know about implementation, billing, and clinical workflows.
Yes. CCN Health integrates with athenahealth so that RPM data flows directly into patient charts, reducing manual documentation and improving care coordination.
RPM uses FDA-cleared connected devices to collect patient vitals—such as blood pressure, weight, and glucose—outside of traditional clinical settings, enabling proactive care and early intervention.
The primary RPM CPT codes are 99453 (device setup), 99454 (monthly device supply/data transmission), 99457 (first 20 min clinical review), and 99458 (each additional 20 min).
Skilled nursing facilities use RPM to continuously monitor residents' vitals, enabling early detection of decline, reducing hospital transfers, and supporting compliance with quality reporting requirements.
Most facilities are fully operational within 2–4 weeks. CCN Health handles device provisioning, EHR integration setup, staff training, and ongoing clinical support.
Still have questions? We're happy to walk you through anything.
Talk to Our Team
Get Started
Ready to bring Remote Patient Monitoring to your Skilled Nursing?
See how CCN Health can improve resident outcomes, preserve independence, support family engagement, and generate new Medicare revenue — all within the EHR your staff already uses.