The evolution of long-term care policy in China is a complex response to the nation's demographic shift and socioeconomic changes. Despite extensive policy development, discrepancies between policy intentions and real-world demands of older adults persist. This commentary dissects the dynamics that have shaped China's aging policies from the 1950s to the present, identifying gaps between policy formulations and market response and the challenges of navigating a fragmented regulatory landscape. A misalignment has emerged between an undersupply of home and community-based services and overstocked institutional care capacity, resulting in resource underutilization and diverging from intended policy outcomes. This commentary further explores the regulatory fragmentation within China's long-term care sector, finding that fragmented supervision is a significant barrier to achieving cohesive governance and effective policy implementation. It illustrates the critical need for adaptive policy mechanisms that better align with demographic realities and consumer expectations. This commentary contributes to the discourses on long-term care policy by offering insights into the effectiveness of China's strategic initiatives in recent years and suggesting directions for future policy refinement.