Across the nation, each organization and every leadership team has become battle-tested during the coronavirus disease 2019 (COVID-19) pandemic. Health care has been impacted in every community, and the mental health toll of the pandemic continues to worsen each day. Key leadership and operational lessons learned during COVID are presented for a health system with 387 care sites, across 160 programs, serving 70,000 patients. General preparedness, maintaining access to care, staffing plan strategies, supporting our employees, and moving forward beyond the pandemic are presented.