It’s a question more and more senior living leaders are quietly asking themselves: What is my therapy department actually doing all day? You see therapists in the building. You know there’s documentation. You may even get the occasional report or update. But if you’re being honest, there’s a real chance you don’t know how the therapy team is spending their time — or whether that time is translating into meaningful care or financial value.
In today’s senior living landscape, where margins are tight and every department is expected to pull its weight, that uncertainty is a problem. Therapy is one of the few departments that directly affects both clinical outcomes and reimbursement potential. So when therapy services are happening in a black box, it’s not just a missed opportunity — it could be quietly draining your margins.
When Therapy Operates in a Silo, Everyone Loses
The most common sign of an underperforming therapy department isn’t open conflict or blatant mismanagement. It’s silence. No questions from leadership. No pushback from therapists. No outcomes being reported. No alignment between therapy and nursing.
In too many buildings, therapy just “does its own thing” — separate from the clinical strategy, the care planning process, and the financial goals of the organization. And that separation is where the problems start.
Therapy Utilization Benchmarks: Are You Below the Line?
One of the biggest blind spots we see is around therapy utilization. Many facilities don’t actually know what their therapy utilization looks like, or what it should be.
For long-term care populations, the industry benchmark is around 30–40% utilization — but many communities are operating far below that, sometimes under 20%, without even realizing it.
That means residents who could benefit from therapy simply aren’t receiving it. Not only is that a missed opportunity for improved outcomes, but it’s also money being left on the table.
Is Your Therapy Team Truly Integrated with Nursing?
Another concern is how therapy integrates into the daily flow of care. Are therapists part of your interdisciplinary team meetings? Do they coordinate closely with nursing? Are they visible on the floor, working with residents in real-time situations — or are they largely isolated in the gym, waiting for scheduled appointments?
In a truly integrated model, therapy isn’t just a department. It’s a partner in resident care. But in many cases, therapy becomes more reactive than proactive, more about checking boxes than driving progress.
If You Can’t Measure It, You Can’t Manage It
This isn’t just about staff behavior — it’s about leadership and alignment. When therapy leadership isn’t held accountable to outcomes, isn’t involved in operational planning, and isn’t regularly reporting performance in ways that tie back to your goals, you lose visibility. And when you lose visibility, you lose control.
Facility leaders should expect therapy to show up in QAPI and stand-up. They should see clear reporting on outcomes, not just productivity. They should ask for data on therapy utilization and look for trends that connect to both care and margin.
Most importantly, they should feel confident that therapy is contributing strategically — not just checking off tasks.
What to Do If You’re Not Sure What Therapy Is Really Doing
The solution isn’t micromanagement — it’s intentional oversight.
If you’re unsure where to start, here are a few questions worth asking: What percentage of our long-term care residents are currently receiving therapy? Is our therapy team participating in IDT, morning stand-ups, or QAPI? Are we receiving regular reports on outcomes, not just therapist productivity? If our therapy provider were gone tomorrow, what would change?
At Gravity Consulting, we’ve worked with dozens of senior living facilities where therapy had become disconnected from the rest of the organization. Sometimes the provider wasn’t delivering. Other times, leadership simply hadn’t asked the right questions. But in nearly every case, pulling back the curtain on therapy operations led to better alignment, better care, and better financial performance.
The Bottom Line: Oversight Drives Outcomes
If you’ve ever wondered what your therapy department is actually doing all day, you’re not alone. And asking that question might be the first step to getting more value from a department that’s capable of driving real results — if it’s managed with clarity and purpose.
Need help assessing your therapy program? We’d be happy to talk through what you’re seeing — or not seeing — and help you determine if it’s time for a closer look.
Call 844-899-6883 to get started.
