Despite consistent bipartisan support, Congress allowed the Acute Hospital Care At Home waiver program to expire after four years and three extensions when it failed to avert a government shutdown. Over 330 hospitals had used this Medicare waiver to start or expand their own hospital at home program to promising results. One such success story, which has been paused until the waiver is reauthorized, comes from UMass Memorial Health in Worcester, MA. We interviewed its Hospital at Home program’s Medical Director, Dr. Taki Michaelidis, to learn how he, his team, and the UMass Memorial system have responded to sudden loss of regulatory approval.