A man remains in custody and will be assessed at a forensic hospital for mental health after allegedly breaking into a nursing home and sexually assaulting an elderly woman.
Brett Anthony Crawford did not front Belmont Local Court on Tuesday after spending the night behind bars, and his Legal Aid solicitor made no application for bail.
The 34-year-old was not required to enter pleas to the serious charges levelled against him after a strike force investigation by the state's Sex Crimes Squad.
Magistrate Stephen Olischlager agreed to endorse Crawford's remand warrant for a mental health assessment at a forensic hospital.
He adjourned the matter to Gosford Local Court in February. Police will work on compiling a brief of evidence in the meantime.
The dramatic arrest on Monday night came after police were told an unknown man broke into an aged care home in the Bateau Bay area on the NSW Central Coast about 12.40am on November 15.
Once inside, police allege Crawford assaulted and sexually assaulted a 90-year-old woman, who had to be rushed to hospital with serious injuries.
Sex Crimes Squad commander Detective Superintendent Jayne Doherty said the alleged victim remained "very traumatised" and was recovering from "very severe wounds to her arms".
"As you can understand, being elderly her skin has torn quite significantly where pressure was applied," she said.
Detective Superintendent Doherty said police had been unable to establish any connection between the accused, the aged care home or the alleged victim, leading police to allege it was an opportunistic attack.
"We understand that the community will be in uproar over this type of offence," she said.
"It's horrendous that someone, any person, in the safety of their home would [allegedly] be attacked like this, but to attack a very defenceless old lady is beyond belief."
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Tuggerah Lakes detectives launched an investigation and combed the crime scene before the State Crime Command's Sex Crimes Squad took over under an operation codenamed Strike Force Easterbrook.
Strike Force detectives, backed by the armoured Raptor Squad, raided a property at The Entrance on Friday night.
They allegedly uncovered electronics, sim cards and clothing relevant to their investigation. The items were seized for further forensic examination.
They warned people not to approach him, and said he may have been travelling on public transport between the Central Coast and Newcastle.
Strike force detectives homed in on Crawford at Caves Beach about 7.30pm on Monday.
He faces allegations of aggravated break-and-enter and commit serious indictable offence using violence; inflicting actual bodily harm with intent to have sexual intercourse; aggravated sexual assault - break-and-enter with intent; and aggravated sexual assault - inflict actual bodily harm.
They were backed by police from Tuggerah Lakes and Lake Macquarie, the regional enforcement squad and the force's transport command.
The man was arrested at the home after allegedly attempting to flee from police.
He was taken to hospital with an arm injury, a police spokesperson said.