Agestrong Health Group | Residential Aged Care Clinical Insight

Could your facility deliver more regular therapy without paying for a Physiotherapist to be onsite for every therapy session?

Residential aged care physiotherapy has traditionally been delivered in a relatively predictable way.

A physiotherapist is rostered onsite for a set number of hours each week.

They assess residents, provide treatment, complete reviews and deliver therapy programs.

For many facilities, this model has worked well.

But the aged care environment has changed.

Resident complexity has increased.

Workforce costs have increased.

Clinical and regulatory expectations continue to evolve.

And the latest AN-ACC increase from 1 October 2026 is only 2.55%, taking the AN-ACC price from $295.64 to $303.19 per resident per day.

StewartBrown has warned that this increase will not cover the true cost of care and will place further pressure on the financial sustainability of residential aged care providers.

So perhaps it is time to ask a different question.

Does physiotherapy have to be delivered the way it always has been?

The answer may be no.

At Agestrong Health Group, we believe there is an opportunity to separate two things that have traditionally been bundled together:

Clinical physiotherapy expertise

and

routine delivery of appropriately delegated therapy.

This doesn’t mean reducing clinical oversight.

In fact, it can allow the physiotherapist to focus more heavily on the clinical work where their expertise is most valuable.

Put the physiotherapist where clinical reasoning matters most

A physiotherapist’s expertise is essential when a resident requires:

• comprehensive assessment
• complex clinical reasoning
• development of an individualised therapy program
• assessment following a fall
• post-hospital review
• clinical reassessment
• equipment recommendations
• management of changing clinical presentation
• pain and mobility assessment
• clinical escalation
• multidisciplinary care planning.

These are areas where physiotherapist expertise is central.

But once a resident has been assessed and an appropriate therapy program established, there may be components of that program that can be delivered by a suitably qualified Allied Health Assistant under appropriate physiotherapist delegation and supervision.

The Agestrong model has been designed around this principle.

A different way to build therapy capacity

Under the Agestrong Allied Health Assistant Supervision Model, the physiotherapist remains responsible for the clinical framework.

They assess.

They plan.

They delegate.

They supervise.

They review.

They reassess.

They escalate when required.

The Allied Health Assistant then provides regular, resident-facing therapy within the delegated program.

This can create something that is increasingly valuable in aged care:

therapy capacity without requiring every therapy hour to be delivered by a physiotherapist.

What about facilities that still need onsite physiotherapy?

This is where we believe the model becomes particularly interesting.

You don’t necessarily have to choose between an Allied Health Assistant model and physiotherapy.

You can combine them.

For example:

Week 1: Physiotherapist onsite for comprehensive assessment and program development.

Weeks 1–4: Allied Health Assistant delivers appropriately delegated therapy.

Scheduled review: Physiotherapist returns onsite to reassess residents, review progress and modify programs.

Between reviews: Additional physiotherapy is accessed when clinically required.

This creates a hybrid model where residents can receive regular therapy while the physiotherapist’s onsite time is concentrated around assessment, review, clinical decision-making and more complex interventions.

What if you don’t need a permanent weekly physiotherapy roster?

There is another option.

Agestrong can provide scheduled locum physiotherapy blocks rather than a standing weekly physiotherapy allocation.

This can be particularly useful for facilities where the clinical requirement is more focused on assessments, reviews and periodic reassessment rather than continuous physiotherapist-led therapy.

Scheduled blocks can be used for:

• new resident assessments
• functional assessments
• falls reviews
• post-hospital reviews
• clinical reassessments
• therapy program reviews
• care planning
• equipment recommendations
• clinical escalation
• other clinically required physiotherapy interventions.

And importantly, this doesn’t have to be an either/or model.

A facility can combine scheduled physiotherapist blocks with an Allied Health Assistant model.

The physiotherapist provides the clinical expertise.

The Allied Health Assistant provides regular delegated therapy.

Additional onsite physiotherapy can be brought in when required.

This is about flexibility — not simply cost reduction

It would be easy to describe this as a cost-saving model.

And yes, financial efficiency is an important consideration in the current environment.

But that isn’t the whole story.

The bigger opportunity is better resource allocation.

If a physiotherapist spends their available hours performing tasks that could appropriately be delegated, the facility may be paying a premium for work that does not always require that level of clinical expertise.

Conversely, if a physiotherapist is only available intermittently because of workforce shortages, residents may not receive the regular therapy they could benefit from.

A well-designed delegated model can help address both issues.

What could this look like in practice?

Consider a 60-bed facility with a relatively stable resident population.

Rather than paying for a fixed weekly physiotherapist roster, the facility could potentially use:

Experienced Physiotherapist

Scheduled onsite blocks for assessment, clinical reviews, reassessment, complex residents and program development.

Allied Health Assistant

Regular onsite delivery of appropriately delegated therapy programs.

Additional Physiotherapy

Accessed when a resident requires an assessment or intervention outside the planned schedule.

This creates a service that can flex around resident need.

It also means the facility isn’t necessarily paying for a fixed number of physiotherapist hours simply because those hours have historically been rostered.

The financial opportunity

Our current modelling indicates that facilities implementing a delegated physiotherapy model may achieve approximately 13–20% reductions in physiotherapy costs, while maintaining a similar level of resident-facing therapy hours.

However, there is no universal saving.

The outcome will depend on:

• number of beds
• resident complexity
• current physiotherapy hours
• current service utilisation
• workforce availability
• existing Allied Health Assistant resources
• required review frequency
• regional travel requirements
• the proportion of therapy that is clinically appropriate for delegation.

This is why we don’t recommend starting with a predetermined number of hours.

We recommend starting with the residents.

Start with the clinical need — then design the model

The most effective service model should answer three questions:

What does the resident need?

What level of clinical expertise is required?

What is the most efficient way to deliver that care safely and effectively?

Sometimes the answer will be direct physiotherapy.

Sometimes it will be Allied Health Assistant-delivered therapy under physiotherapist supervision.

Sometimes it will be virtual review.

Sometimes it will be scheduled onsite physiotherapy.

And sometimes it will be all of the above.

The future of aged care physiotherapy may be more flexible than we think

The current funding environment is forcing difficult conversations across residential aged care.

But those conversations can also create opportunities to rethink traditional service models.

We don’t have to choose between quality and financial sustainability.

We can instead ask whether our current models are making the best possible use of the clinical workforce available to us.

At Agestrong Health Group, our approach is simple:

Use the right clinician, for the right task, at the right time.

Keep the physiotherapist at the centre of clinical decision-making.

Build regular therapy capacity around appropriately delegated activities.

Use scheduled onsite physiotherapy where clinical expertise is required.

Bring in additional physiotherapy when residents need it.

And build a service model that can change as your resident population changes.

Because in today’s aged care environment, flexibility isn’t a luxury.

It is becoming a clinical and operational necessity.