The United States (US) currently has the most confirmed cases of COVID-19 of any country. Yet, adequate testing for the virus remains a major issue. Approximately 51.6 million Americans are over the age of 65 and 56 percent of adults over 65 are living with two or more chronic conditions (23 percent have 3 or more). Given the higher risk of death and complications associated with advanced age and underlying health conditions, COVID-19 has had an immense impact upon LTC in the United States. Yet, the level and intensity of impact has been sporadic in application. This is due in part to a highly disparate and fractured long-term care system and perennial systemic challenges that have been exacerbated by the pandemic. In terms of financing care, the US relies on a mix of public and private funding sources. Further, individual states and the federal government have overlapping responsibility for funding and regulation of care. Meanwhile, fragmentation between financing and ownership of health care entities versus long-term care entities hinders coordinated delivery of care across sectors; and social sectors and health care sectors are also not integrated. The challenges of the system’s design suggest that both a near-term and long-term response is needed to mitigate the impact of COVID-19 on the approximately 13 million Americans who require long-term care. This report provides an overview of the current challenges facing LTC and outlines several potential policy responses to the pandemic as well as for life post-pandemic.