Relevance. COVID-19 remains an urgent disease for long-term care institutions (LTCI), because local outbreaks of COVID-19 continue to be registered in 2022 and in 2023.Aims. To study the epidemic process of COVID-19 in LTCI (nursing homes, neuropsychiatric boarding schools) in Moscow for 2020–2022.Materials and methods. The analysis of the epidemic process of COVID-19 in LTCI was carried out for the period 2020–2022. Data of Automatic information system «Department of Registration and Accounting of Infectious Diseases was used: 5390 COVID-19 residents and employees of 28 institutions in Moscow and 3,239,617 residents of Moscow; 15 acts of epidemiological investigation of the focus of infectious disease in the period from 2020 to 2022.Results. In total, 9 increases in the incidence of COVID-19 were registered. The first rise was the most intense, which affected morbidity (81.14 per 1,000 beds per week), indicators of activity of epidemic foci (KO – 100%, IO – 21.08, R – 20.08), mortality (for 2020 – 32.6%). In the first rise of morbidity in nursing homes, there is a direct correlation of a high degree of connection with the morbidity of the population of Moscow (r = 0.906), and for subsequent rises there is a noticeable relationship (r = 0.580) at p<0.05. From 2 to 9 rises, the incidence tended to decrease. All the rises of COVID-19 occurred due to the formation of foci in institutions where the source of infection was employees. For 2020–2022, the proportion of severe cases of infection with a fatal outcome among residents ranged from 14.6 ±6.7% to 31.8 ± 6.5%.Conclusion. The analysis of the manifestations of the COVID-19 epidemic process in long-term care institutions in Moscow for 2020–2022 allowed us to distinguish two stages of morbidity.