PCM for Skilled Nursing
Principal Care Management for Skilled Nursing — Powered by PointClickCare + CCN Health
Purpose-built PCM for Skilled Nursing communities. CCN Health integrates directly with PointClickCare to automate clinical workflows and capture every eligible reimbursement.
CCN Health provides a certified Principal Care Management (PCM) integration with PointClickCare designed specifically for skilled nursing facilities, bridging both PointClickCare and augusthealth systems. The platform automates clinical documentation, enables real-time monitoring, and generates Medicare billing records for compliant reimbursement.
PCM for Skilled Nursing with PointClickCare and August Health
Many skilled nursing facilities use PointClickCare as their facility EHR while the ordering physician or medical director uses August Health for their practice. This dual-EHR reality creates challenges for PCM programs — clinical data lives in two systems that don't natively talk to each other. CCN Health solves this by integrating with both systems simultaneously.
The Dual-EHR Challenge in Skilled Nursing
In skilled nursing settings, it's common for:
- The facility to use PointClickCare for resident records, charting, and daily care documentation
- The physician to use August Health for orders, billing, and clinical decision-making
- PCM data to be needed in both systems for complete clinical documentation
Without an integration bridge, nursing staff must manually enter data in both systems, leading to documentation gaps, billing delays, and clinical risk.
How CCN Health Bridges PointClickCare and August Health
CCN Health's platform sits between both EHR systems, serving as a central hub for all PCM data:
- Device data flows to CCN Health — Vital signs from monitoring devices are captured by the CCN Health platform
- PointClickCare receives resident records — Vital signs, alerts, and care documentation sync to PointClickCare resident charts
- August Health receives clinical summaries — The ordering physician gets PCM reports, clinical observations, and billing-ready documentation in their August Health workflow
- Billing documentation routes correctly — Claims data goes to the billing entity (physician practice via August Health) with supporting clinical documentation
Data Flow: PointClickCare ↔ CCN Health ↔ August Health
| Data Type | PointClickCare | CCN Health | August Health |
|---|---|---|---|
| Resident Demographics | Source | Syncs | Receives |
| Vital Signs | Receives | Hub | Receives |
| Clinical Alerts | Receives | Generates | Receives |
| Care Plans | Shared | Coordinates | Shared |
| Billing Documentation | Reference | Generates | Primary |
| PCM Time Tracking | Reference | Tracks | Primary |
Why This Matters for Skilled Nursing
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.
Billing Considerations for Dual-EHR PCM
In dual-EHR environments, billing typically flows through the physician practice (August Health):
| CPT Code | Reimbursement | Billing Entity | Documentation Source |
|---|---|---|---|
| 99424 | ~$70/mo | Physician (August Health) | CCN Health → August Health |
| 99425 | ~$56/mo | Physician (August Health) | CCN Health → August Health |
| 99426 | ~$80/mo | Physician (August Health) | CCN Health → August Health |
| 99427 | ~$64/mo | Physician (August Health) | CCN Health → August Health |
CCN Health ensures all required documentation is routed to the correct system for compliant billing regardless of which entity submits the claim.
Frequently Asked Questions
Do both EHR systems get the same PCM data?
Both systems receive PCM data, but the content is tailored to each system's role. PointClickCare gets resident care documentation, while August Health receives clinical summaries and billing records.
Who submits the Medicare claims?
Typically the physician practice bills through August Health, with CCN Health providing all required documentation. The specific billing arrangement depends on your organization's structure.
Is there extra setup for dual-EHR integration?
CCN Health configures both integrations during the standard implementation period. The dual-EHR setup is part of our standard offering — no additional cost or extended timeline.
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 PointClickCare
Your program data flows directly into PointClickCare — no exports, no manual entry, no disruption to your clinical workflow.
Specialist Data
Condition Monitoring, Referrals
AI-Powered Platform
Intelligent data routing, anomaly detection, and automated documentation — working behind the scenes.
PointClickCare
Charts & Care Plans
What Flows Between Systems
Patient Demographics
High-risk conditions, specialist data, and medications
Condition Tracking
Disease-specific metrics monitored and trended
Specialist Coordination
Referral data and specialist notes synchronized
Care Plans
Condition-specific treatment plans inform monitoring
Time Tracking
Care management minutes tracked for billing compliance
Billing Documentation
CPT 99424/99425/99426/99427 records generated automatically
“Every reading, every alert, every care plan update — available across all your programs. One integration, unlimited use cases.”
Infrastructure
Medicare Billing
Automated Medicare billing documentation — every qualifying encounter captured and coded.
Medicare Billing
Principal Care Management (PCM)
2 billing codes
First 30 minutes of clinical staff time for PCM
~$70
Monthly
Each additional 30 minutes of PCM clinical staff time
~$54
Monthly (additional)
Common Questions
Frequently Asked Questions
Everything you need to know about implementation, billing, and clinical workflows.
Yes. CCN Health has a direct integration with PointClickCare, allowing vital-sign data from RPM devices to flow automatically into resident charts without manual entry.
Device readings are transmitted to CCN Health's platform and then pushed into PointClickCare via API, appearing alongside existing clinical documentation for a unified workflow.
PCM focuses on patients with a single high-risk chronic condition, billed under CPT codes 99424 and 99425, covering care coordination and management services.
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