The long-term care field, often referred to as long-term services and supports (LTSS), is experiencing significant changes just as the demand for these services is about to grow exponentially.  This presentation will provide an overview of the changing LTSS landscape, focusing on trends related to the triple knot of long-term care - a term the speaker uses to describe the intersection of financing, delivery and workforce.  Following a brief review of the demographics driving the increasing demand for these services and supports, the presentation will highlight key financing trends, including the expansion of managed LTSS across the states;  bundled payments for post-acute care;, the growth in the home and community-based care; and home-based primary care sectors; the opportunities for LTSS benefits to be provided through Medicare Advantage; and an increasing focus on the role of LTSS helping health systems address the social determinants of health.  The discussion will then turn to the implications of these trends for providers across the full range of settings, including the future of the nursing home; new life for assisted living through memory care; and the potential for independent living to serve as a platform for service coordination and integration.  The presentation closes with a discussion of the workforce crisis facing the LTSS sector, and potential solutions to recruitment and retention, including the role of technology.