Equine-assisted services (EAS) is a relatively new area of study within higher education requiring the development of a curriculum that best prepares the undergraduate student for the demands of the industry. Further, coursework targeting the specific management challenges for ensuring the welfare of horses utilized within EAS is limited. Therefore, the objective of this study was to apply an industry-based survey assessment utilizing EAS professionals within the United States to document management practices associated with healthcare and pain management challenges in the EAS horse. Suggested curriculum for undergraduate students targeting a career in EAS is given, utilizing data collected from the survey. Participant responses (n = 30) indicated that all of the surveyed facilities cared for more than three geriatric horses within their program, with the majority (60% responding “definitely yes”) utilizing regularly functionally lame horses, although the prevalence of lameness was not correlated with number of geriatric horses within a program (0.20, p = 0.22). While lameness is a common healthcare challenge within EAS, gastrointestinal conditions (73%) were one of the other leading health concerns for these facilities. The most common equine pain detection method for EAS facilities was behavior assessment (93%), in which this method was positively correlated with years of horse experience (0.51, p = 0.01). Horse pain was primarily managed through annual alternative therapeutic interventions (76%), daily prescriptions (73%), and nutritional supplements (73%). As such, the curriculum for undergraduate EAS degree programs should cover healthcare practices targeting geriatric horse management and associated health issues such as gastrointestinal conditions and lameness, including early detection and pharmaceutical, nutritional, and alternative therapeutic treatments.