In healthcare, preventing acute deterioration in activities of daily living (ADL) and quality of life is critical since sustaining ADL can lead to a healthy and joyful life. Frailty is a risk factor for being unable to maintain ADL, and constant exercise is essential for older adults to prevent the progression of frailty. In rural contexts, older people’s frailty is prevalent. We suggested a method for providing exercise programs in collaboration with family physicians in rural settings, respecting the characteristics of rural older people. The concrete implementation was established based on the ecological model and stakeholder analysis. Four plan, do, study, and act cycles were discussed through collaboration with various professionals. For the implementation and sustainability of rural exercise programs, gradual and logistic planning and progression are critical. Family physicians can be one of the drivers for the smooth implementation of rural exercise programs based on the social assessment and ecological model.