The present paper aims to reveal the main problems that the long-term care system in Spain faced during COVID-19, outline its main challenges, and reflect on how the response to the pandemic has been tackled to provide a basis, in terms of prevention, for future similar scenarios. For this purpose, two scoping reviews were conducted. The first identified the main socio cultural characteristics of the care system in Spain, described the multi-level model regarding the institutional architectures, and exposed the consequences of the development of the Dependence Act and the impact of the 2008 crisis. The second established the main emergent topics in scientific production regarding long-term care and older people that have emerged due to COVID-19. The contrast in the results shows the structural deficiencies of the long-term care system and the need for profound changes, such as the restructuring of the retirement home system to adapt it to pandemic scenarios and the prioritization of the path of deinstitutionalization, as long as this is carried out with the reinforcement of social assistance mechanisms and appropriate community assistance resources.