PCM · Blood Glucose
Blood Glucose Monitoring for Skilled Nursing PCM — ALIS + CCN Health
Blood Glucose Monitoring technology powering your PCM program in Skilled Nursing — fully integrated with ALIS. Real-time alerts, clinical workflows, and automated billing in one platform.
Hundreds of facilities just like yours have grown their Principal Care Management programs with CCN Health. .
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Not ready for a call? No problem. Drop us a message and we'll get back to you within 24 hours with answers to your questions about Principal Care Management for your Skilled Nursing.
Tell us about your organization
Share details about your Skilled Nursing, current EHR setup, and what you're looking to achieve.
We'll review and respond
Our team will assess your needs and send you relevant information, case studies, or suggest next steps.
Connect when you're ready
When the time is right, we'll schedule a personalized demo tailored to your workflows.
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We'll get back to you within 24 hours.
CCN Health provides a certified Principal Care Management (PCM) integration with ALIS designed specifically for skilled nursing facilities, featuring glucose monitoring technology. The platform automates clinical documentation, enables real-time monitoring, and generates Medicare billing records for compliant reimbursement.
Glucose Monitoring for Skilled Nursing PCM with ALIS
Glucose Monitoring brings a distinct advantage to PCM programs in skilled nursing facilities. FDA-cleared blood glucose meters from Trividia Health and Smart Meter use fingerstick testing with automatic cellular transmission. Results transmit to the CCN Health platform within minutes without patient interaction beyond the test itself. Combined with CCN Health's ALIS integration, residents benefit from continuous monitoring without additional nursing staff burden.
Why Glucose Monitoring for Skilled Nursing
Skilled Nursing facilities serve post-acute and long-stay residents requiring 24/7 skilled nursing care, often with multiple comorbidities and higher acuity. Glucose Monitoring is particularly relevant because:
- Familiar fingerstick method — minimal learning curve
- Automatic cellular transmission eliminates manual logging
- Real-time alerts for dangerous highs (>300) and lows (<70)
How Glucose Monitoring Works
FDA-cleared blood glucose meters from Trividia Health and Smart Meter use fingerstick testing with automatic cellular transmission. Results transmit to the CCN Health platform within minutes without patient interaction beyond the test itself.
Data Captured
- Fasting blood glucose
- Postprandial glucose
- Blood glucose trends
- Hypoglycemia events
- Hyperglycemia events
Benefits for Skilled Nursing Facilities
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.
Glucose Monitoring vs. Traditional Approaches
| Factor | Glucose Monitoring | Traditional |
|---|---|---|
| Test Method | Fingerstick with auto-upload | Fingerstick with manual logging |
| Data Transmission | Cellular — instant to platform | Paper log or manual entry |
| Alert Capability | Real-time hypo/hyperglycemia alerts | No alerting — reviewed later |
| Cost | Lower than CGM | Similar test strip costs |
| Clinical Oversight | 24/7 monitoring with escalation | Reviewed at appointments |
Common Conditions in Skilled Nursing
- post-surgical recovery
- heart failure
- pneumonia
- COPD exacerbation
- sepsis recovery
- wound care
Billing & Reimbursement
Glucose Monitoring data contributes to PCM billing in skilled nursing settings:
| CPT Code | Reimbursement | Requirements |
|---|---|---|
| 99424 | ~$70/mo | 30+ minutes of clinical staff time per month |
| 99425 | ~$56/mo | Each additional 30 minutes of clinical time |
| 99426 | ~$80/mo | 30+ minutes of physician/QHP time |
| 99427 | ~$64/mo | Each additional 30 minutes of physician time |
Monthly potential per resident: $70+
Frequently Asked Questions
Is glucose monitoring suitable for skilled nursing residents?
Yes. Glucose Monitoring is ideal for skilled nursing glucose management, where familiar fingerstick method — minimal learning curve.
How does glucose monitoring data reach ALIS?
Data flows automatically from the monitoring system to CCN Health's platform, then syncs bi-directionally with ALIS. No manual charting required.
What is the implementation timeline?
Most skilled nursing facilities are fully operational within 4 weeks including system deployment, ALIS integration, and nursing staff training.
Discovery call — we learn your workflows, EHR setup, and patient population so nothing gets lost in translation.
We configure your platform around how your team actually operates — custom alert thresholds, EHR data mapping, and role-based permissions.
Go live with monitoring, automated documentation, and billing tailored to your practice — your team stays focused on care.
No one-size-fits-all templates. Every integration is configured for how your Skilled Nursing actually operates.
Configurable Alerts
Set thresholds that match your clinical protocols
Flexible Workflows
Adapt routing, documentation, and permissions to your team
Automated Compliance
Real-time audit trail and billing validation
Advanced technology working behind the scenes — so your team gets faster processing, smarter alerts, and effortless documentation without changing how they work.
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.
Questions?
Want to learn more about Principal Care Management for Skilled Nursing?
Our team can answer your questions and show you how it works with your current workflow.
Seamless EHR Integration
How CCN Health Works Inside ALIS
Your program data flows directly into ALIS — no exports, no manual entry, no disruption to your clinical workflow.
Specialist Data
Condition Monitoring, Referrals
Built Around How You Operate
Custom workflows, smart alerting, and automated documentation — advanced technology working behind the scenes so your team doesn't have to.
ALIS
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
Devices & Billing
FDA-cleared devices and automated Medicare billing — configured per resident, synced with the EHR.
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 integrates with the ALIS platform so that RPM readings sync directly into resident records, streamlining clinical workflows for senior living communities.
CCN Health transmits device data to ALIS through a secure API, ensuring vitals are available to caregivers inside the EHR they already use every day.
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.
Patients use a connected blood glucose meter to take readings that transmit automatically to CCN Health's platform, supporting diabetes management with real-time trend visibility for clinicians.
Still have questions? We're happy to walk you through anything.
Contact Us
Prefer to Send a Message?
Not ready for a call? No problem. Drop us a message and we'll get back to you within 24 hours with answers to your questions about Principal Care Management for your Skilled Nursing.
Tell us about your organization
Share details about your Skilled Nursing, current EHR setup, and what you're looking to achieve.
We'll review and respond
Our team will assess your needs and send you relevant information, case studies, or suggest next steps.
Connect when you're ready
When the time is right, we'll schedule a personalized demo tailored to your workflows.
Send Us a Message
We'll get back to you within 24 hours.
Get Started
Ready to bring Principal Care Management 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.