Key Takeaways This article describes the conversion of an acute care hospital into a dedicated COVID-19 treatment center at the beginning of the pandemic and details the safety and emergency management challenges and lessons learned. Among the lessons learned is that communication is essential, including collaboration between many departments and specialties. Also key are the active involvement and support of senior leadership in safety and health decisions, as well as the early involvement of community partners and resources. Finally, flexibility is needed without compromising employee safety and health. Beginning in March 2020, a 123-bed community acute care hospital was converted into a dedicated COVID-19 treatment center. Given the nature of the pandemic, the site conversion involved expanding intensive care capabilities from six to 70 beds, with an additional 88 general medical beds (Gold et al., 2020). Safety and emergency management remained a clear focus during the commissioning and operation of the COVID-19 treatment center. This article presents specific challenges, resolutions and overall key lessons learned for success in safety and emergency management. The unique ability to discharge all but one COVID-19 positive intensive care unit patient, discontinue for 1 week all patient-related services including emergency services and surgeries, and implement a preplanned concept of operations allowed for a successful transition and established the framework for the facility’s new mission.