Being a hospital network, for better or worse, our day to day operations often depend on a regular stream of communication and feedback from the Centers for Medicare and Medicaid Services (CMS).
Generally, even though the federal government is not known for their speed when doing much of anything, our communications with CMS often proceeded on a regular of enough schedule so as not to impact business operations.
That is until whispers of the potential for a government shutdown began to emerge in our conversations with CMS early last week. And even though they were mere rumors at the time, our team could begin to feel an appreciable change in the pace and tone of our communications almost immediately.
Those at CMS who had been there the longest began to take on the tone of doomsday preppers wondering if it would last as long as the infamous 1995 – 1996 shutdown, or if it would be more comparable to 2013. In either event, it was clear they were focused on buttoning down the hatches for the impending storm and had put many of their day to day tasks on the back-burner.
Frustrating as it may have been for our hospital, it was admittedly hard to blame the staff at CMS. The career civil servants we dealt with were concerned what would happen if they did not receive their next paycheck or were furloughed indefinitely, a very understandable worry. Yet we still had a hospital to run and we depended on our regular interactions for guidance.
To answer the obvious question, yes, CMS was committed to maintaining all “essential employees” for the duration of the shutdown, but it was clear the definition of essential was still a work in progress.
After several days of hearing from our CMS friends to prepare for the worst, I fully expected C-SPAN to go dark at 12:01 AM this past Saturday. Yet as midnight tolled, nothing changed. Even as the sun rose on Monday morning, our CMS partners were still at work, but preparing to send non-essential employees home at lunch.
However, before I could breathe a sigh of relief, I received an out-of-office reply to an e-mail I sent to one of our regular attorney counterparts at CMS informing me they were not in the office, nor checking e-mails, due to the shutdown. My subsequent e-mail to her boss was also met with a similar automatic reply.
Thankfully before full panic mode on my part could set-in, the Senate seemingly came to their senses and agreed to reopen the government. But while the great shutdown of 2018 will be counted in hours and not days, the impact of those hours are still being felt now several days later as CMS, and the rest of the federal government, continues to shake off the dust and return to normal operations.
While the actions of the federal government always make for an easy and ripe target, my narrow experience with CMS this past week did raise some very practical considerations for my hospital’s own operations.
What would happen if several members of my team were absent for more than a day? How would we function if we had to operate on with an unexpected reduction in revenue? Would we be able to sustain normal operations with only “essential employees,” whoever they may be?
As in-house attorneys faced with the mundane day to day legal questions, you may not think disaster management could possibly fall to you in the event of an emergency, but when the unexpected strikes, all bets are off.
In times of crisis, legal is often one of the first departments a company’s executive leadership turns to for guidance.
And while I sincerely hope disaster should never befall your organization, as demonstrated by this past week, a little forethought and preparation can save a great deal of worry and heartache in the long run.
Stephen R. Williams is in-house counsel with a multi-facility hospital network in the Midwest. His column focuses on a little talked about area of the in-house life, management. You can reach Stephen at stephenwilliamsjd@gmail.com.
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