In the world of long-term care, therapy services are often one of the most underutilized — and misunderstood — components of resident care and facility performance.
Occupational, physical, and speech therapy aren’t just services to check off a regulatory list. When aligned with resident needs and reimbursement strategy, they directly impact outcomes, satisfaction, compliance, and yes — financial health.
But there’s a question we hear all the time:
“How do I know if our therapy utilization is where it should be?”
It’s a smart question. And the answer isn’t just about numbers — it’s about understanding the story those numbers tell.
What Is Therapy Utilization, Really?
At its core, therapy utilization refers to how many of your long-term care (LTC) residents are actively receiving therapy services. That might sound straightforward, but it’s not just about how many sessions are being billed.
Utilization reflects how therapy is integrated into the daily fabric of your care model — and whether it’s being used as a proactive tool or a reactive patch.
Too low, and it raises concerns:
- Are residents being overlooked?
- Is functional decline going unaddressed?
- Is staff missing the signs of rehab potential?
Too high, and it might prompt different questions:
- Are therapy resources being stretched thin?
- Are services being driven by volume instead of clinical need?
- Could documentation withstand a closer look?
That’s why benchmarks exist — not to dictate policy, but to help facilities assess where they fall on the spectrum and explore why.
So, What’s Normal?
Let’s talk numbers. While there’s no universal standard (and every facility is unique), general industry benchmarks for therapy utilization in LTC settings often look like this:
- Skilled Nursing Facilities (SNFs):
Utilization typically ranges from 30% to 40% of LTC residents receiving some form of therapy. - Assisted Living Facilities (ALFs):
Lower acuity usually results in 20% to 25% utilization. - Independent Living (IL):
Often falls in the 10% to 15% range.
These figures fluctuate based on resident acuity, provider type (in-house vs. contract), staffing, facility size, and care philosophy.
But here’s the important part: if your numbers are significantly lower — or haven’t changed in years — it’s worth asking if they truly reflect the needs of your residents.
Why Low Utilization Isn’t Always a Good Thing
It’s tempting to look at a low utilization rate and see efficiency or cost savings. But in long-term care, low therapy usage is more often a warning sign than a badge of honor.
If your LTC unit shows only 10–15% utilization, that may indicate:
- Missed opportunities for maintaining resident function
- Increased fall risk and hospitalization rates
- Shorter lengths of stay and lower resident satisfaction
- Lack of staff training to identify candidates for therapy
- Poor coordination between nursing and rehab teams
In short: underutilization often signals a reactive therapy culture — one where services are delivered after a decline or incident, not to prevent one.
And that costs more in the long run.
Beyond the Numbers: What Benchmarks Can’t Tell You Alone
The value of a benchmark is only as good as the context behind it. Two facilities might both sit at 35% utilization, but one might be maximizing outcomes while the other is simply coasting.
Here are a few deeper questions leaders should be asking:
- Are therapists present and engaged on the floor — or just tucked in a rehab gym?
- Are therapy screenings routine or only done upon request?
- Do nursing and therapy teams collaborate on care plans and restorative programming?
- Are there systems in place to re-evaluate therapy potential after hospitalization, illness, or observed decline?
Benchmarks give you a place to start. But internal processes — communication, workflows, accountability — determine whether those numbers reflect actual clinical value.
How to Start a Conversation Around Utilization
If your therapy utilization feels “off” (too low, too high, or simply flat), here are a few non-threatening ways to open the dialogue with your team:
- “How do we currently identify residents who would benefit from therapy?”
If the answer is vague or inconsistent, there’s a gap worth exploring. - “When was the last time we audited therapy referrals or outcomes by unit?”
Trends in referrals or outcomes can reveal blind spots. - “Are we regularly reviewing therapy eligibility as part of care conferences?”
This is often missed — and easily corrected. - “What’s our process for re-screening long-term care residents?”
Especially after a health event, return from hospital, or notable decline.
You don’t need a full overhaul to improve therapy utilization. Often, a few process improvements or a change in how therapy is integrated into care planning can unlock immediate gains.
Final Thoughts: Normal Isn’t Always Good Enough
Knowing what’s “normal” is only the beginning. The real question is:
“Is our therapy program meeting the true needs of our residents?”
If the answer is “I’m not sure,” you’re not alone — and that uncertainty is exactly where smart operators begin their improvement journey.
Because in long-term care, the difference between maintaining function and functional decline often comes down to one thing:
Whether therapy is built into your facility’s DNA — or treated like an optional extra.
P.S.
If you’re wondering whether your therapy program is truly aligned with your residents’ needs and your facility’s goals, you’re not alone. We’ve helped dozens of organizations uncover hidden gaps, improve utilization, and regain control over their therapy outcomes.
For a deeper dive into the financial and clinical risks of underperforming therapy programs, download our free resource:
7 Ways Contract Therapy Is Draining Your Margins
It’s a quick read with practical insights you can apply immediately — whether you manage therapy in-house or through a contract provider.
