MatrixCare
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CCN Health

EHR Integration Partnership

Remote Monitoring for Post-Acute & Senior Living

CCN Health integrates with MatrixCare — the EHR and care management platform by ResMed — to power RPM, CCM, PCM, BHI, and RTM programs across skilled nursing, senior living, and home health. API integration syncs resident data and writes vitals back to clinical records.

Integration Overview

Full continuum, five programs.

A single API connection between MatrixCare and CCN Health unlocks every Medicare remote care program across the full post-acute care continuum.

5
Medicare Programs
RPM, CCM, PCM, BHI, RTM
15K+
Facilities
MatrixCare's network
Full
Continuum
SNF to home health
4 wk
Deployment
Configuration to go-live

Platform Integration

The CCN Health platform.

Clinical data flows bidirectionally between MatrixCare and CCN Health — vitals, alerts, and billing documentation sync automatically without leaving the EHR.

MatrixCare

MatrixCare

Demographics & ADT
Medications & Allergies
Vitals & Readings
Clinical Alerts
Billing Documentation
Compliance Records
CCN Health
Live
Margaret Chen
RPM • Day 18 of 30
Blood Pressure
128/82
mmHg • 2m ago
SpO₂
97%
Pulse Ox • 2m ago
Weight
168 lbs
Scale • 8:12am
Glucose
112 mg/dL
CGM • 5m ago
BP elevated — alert sent to care team

CCN Health Platform

Bidirectional Sync

Data flows both ways.

This isn't a one-way data dump. MatrixCare shares clinical context with CCN Health to inform monitoring protocols, and CCN Health writes vitals, alerts, and billing documentation back — so caregivers never leave the EHR.

MatrixCare
CCN Health

From MatrixCare to CCN Health

Resident Demographics

Census data, ADT events, insurance, contacts, facility assignments

Care Plans & Assessments

Clinical assessments, care plans, MDS data, acuity levels

Clinical Documentation

Progress notes, physician orders, diagnosis codes, lab results

Medication Records

Active medications, eMAR data, pharmacy integration records

From CCN Health to MatrixCare

Vital Sign Readings

BP, weight, glucose, SpO2, temperature — posted to resident records

Clinical Alerts

Threshold breaches, trending changes, escalation notifications

Billing Documentation

CPT-coded time logs, device transmission records, compliance audit trails

Program Status

Enrollment status, compliance metrics, program performance data

Programs Powered

Five programs, every setting.

The MatrixCare integration powers every Medicare-reimbursable remote care program — across skilled nursing, assisted living, home health, and the full post-acute continuum.

01
RPM

Remote Patient Monitoring

Continuous vital sign collection from connected devices, trended in CCN Health and synced to MatrixCare resident records.

CPT Codes

99453, 99454, 99457, 99458

02
CCM

Chronic Care Management

Non-face-to-face care coordination for residents with 2+ chronic conditions. Care plans documented in both platforms.

CPT Codes

99490, 99491, 99437

03
PCM

Principal Care Management

Specialist-level management for a single high-complexity condition. Coordination notes sync to MatrixCare care plans.

CPT Codes

99424, 99425, 99426, 99427

04
BHI

Behavioral Health Integration

Psychiatric collaborative care for residents with behavioral health conditions. Assessment data enriches clinical profiles.

CPT Codes

99484, 99492, 99493

05
RTM

Remote Therapeutic Monitoring

Non-physiological data monitoring — therapy adherence, respiratory device usage, medication compliance tracking.

CPT Codes

98975, 98976, 98977, 98980, 98981

Care Settings Powered

Across every supported environment

Skilled Nursing
Senior Living
Assisted Living
Home Health
Long-Term Care
CCRC
Independent Living
Memory Care

What This Enables

From data to clinical decisions.

The MatrixCare integration transforms how post-acute and senior living communities deliver, document, and bill for remote care programs.

Automated Vital Sign Charting

Device readings flow directly into MatrixCare resident records — no manual entry, no transcription errors, no workflow disruption.

ADT-Driven Enrollment

Admission, discharge, and transfer events from MatrixCare trigger enrollment workflows. Census changes automatically update monitoring protocols.

Compliant Billing Documentation

CPT-coded time logs and device transmission records auto-generate — satisfying CMS documentation requirements for all five programs.

Real-Time Alert Workflows

Vital sign threshold breaches trigger alerts inside MatrixCare workflows — reaching staff where they already work.

Unified Resident Record

RPM data, CCM notes, and billing records all live in the MatrixCare resident profile alongside care plans and clinical documentation.

Multi-Facility Visibility

Operators managing multiple facilities see aggregated program performance — enrollment, compliance, and revenue metrics across the portfolio.

Connected Devices

Every reading, charted automatically.

Residents take a measurement. The device transmits to CCN Health. CCN Health writes the reading into their MatrixCare record. Staff see it on their next chart check.

DeviceConnectivityData Synced to MatrixCare
Blood Pressure CuffCellular-connectedSystolic, diastolic, pulse, irregular heartbeat flag
Weight ScaleCellular-connectedWeight, BMI, trend alerts for fluid retention
Pulse OximeterCellular-connectedSpO2, pulse rate, perfusion index
Blood Glucose MeterCellular-connectedGlucose level, pre/post meal tagging
Continuous Glucose MonitorBluetooth/cloud288 readings/day, trend arrows, time-in-range
ThermometerCellular-connectedTemperature, fever detection alerts
Sensorless MonitorUWB radarHeart rate, respiratory rate, sleep, presence
Sleep TrackerUnder-mattressSleep duration, efficiency, restlessness

Integration Preview

Built into the platform.

CCN Health's clinical dashboard and mobile app integrate directly with MatrixCare — vitals, alerts, trending, and billing documentation all flow through a single unified interface.

app.ccnhealth.com
CCN Health clinical dashboard showing MatrixCare integration with patient vitals, blood pressure trending, alerts, and clinical notes
MatrixCare×CCN Health

Caregiver Mobile App

Staff use the CCN Health mobile app to take vitals at the bedside. Select a patient, choose a device, and the reading flows directly into MatrixCare — no manual charting required.

Scan vitals with Bluetooth devices at the bedside
Readings auto-chart to the patient's EHR record
Patient list syncs from MatrixCare census
Works offline — syncs when connectivity returns
CCN Health mobile app showing patient list, device selection, and Bluetooth scanning

Clinical Specialties

Specialty-specific protocols.

CCN Health's monitoring protocols are tuned per specialty — the MatrixCare integration ensures the right data reaches the right clinicians.

Cardiology

Blood pressure, heart rate, weight management

Endocrinology

Glucose monitoring, CGM, metabolic tracking

Pulmonology

SpO2, respiratory rate, sleep apnea screening

Nephrology

Weight, blood pressure, fluid balance

Behavioral Health

BHI programs, medication compliance, sleep

Geriatrics

Fall risk, activity monitoring, comprehensive vitals

Implementation

Live in four weeks.

From API credentialing to production data flow, the standard MatrixCare integration deployment takes four weeks.

01
Week 01

API Credentialing & Setup

MatrixCare API credentials provisioned, data scope defined, HIPAA BAA executed. CCN Health configures facility mapping and resident matching.

02
Week 02

Integration Testing

Data flow validated in MatrixCare test environment. Census sync confirmed, vital sign posting tested, alert routing verified.

03
Week 03

Device Deployment & Training

Monitoring devices provisioned and assigned to enrolled residents. Staff training on CCN Health dashboard and MatrixCare integration.

04
Week 04

Go-Live & Optimization

Production data flowing. Alert thresholds tuned per clinical protocols. Billing documentation validated. Ongoing support.

About MatrixCare

Post-acute care platform by ResMed.

MatrixCare, a ResMed company, is a leading technology platform for out-of-hospital care settings. Serving over 15,000 facilities across the US, MatrixCare provides EHR, financial management, care coordination, and analytics solutions across the full continuum of post-acute care — from skilled nursing and senior living to home health and hospice.

Clinical — EHR, eMAR, physician orders, MDS/OASIS assessments, care plans
Financial — Billing, claims, revenue cycle management, accounts receivable
Care Coordination — Referral management, transitions of care, hospital partnerships
Analytics — Quality measures, benchmarking, operational dashboards, predictive insights
Home Health & Hospice — Point-of-care documentation, scheduling, OASIS assessments
Marketplace — Integrated partner solutions for extended functionality
15,000+ facilities
|ResMed company
|Full post-acute continuum
MatrixCare

Ready to activate remote care programs in MatrixCare?

See how CCN Health powers RPM, CCM, PCM, BHI, and RTM directly inside the MatrixCare platform your staff already uses.

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