As a family physician and a family nurse practitioner in a Federally Qualified Health Center in rural Maine, we experienced a COVID-19 outbreak at our local long-term care facility, which involved 32 patient cases, 11 staff cases, 19 recovered cases, and 13 deaths over 34 days in April 2020. There were many lessons to be learned that may inform and guide others or help prevent facilities from facing some predictable challenges.