Court Opinion

ID: 9482405
Source: CourtListenerOpinion
Date Created: 2023-08-05 08:49:10.502539+00
Date Added: 2024-06-11T17:48:58.126105
License: Public Domain

CYR, Circuit Judge
(concurring, in part; dissenting, in part).
I concur in Part I of the opinion, but respectfully dissent from the conclusion reached in Part II. The majority opinion concludes that the consent decree definition of “institution” is too vague or ambiguous to permit the interpretation given it by the district court. The majority seems most concerned that appropriate respect for the integrity of Commonwealth governmental institutions and the principles of federalism would be disserved by the district court’s interpretation of its jurisdiction under the consent decree. Although federalism concerns and the integrity of Commonwealth governmental institutions merit earnest consideration, the threat perceived by the majority is exaggerated.
The district court, plainly mindful of the attendant implications,27 fairly interpreted the negotiated consent decree, employing entirely appropriate interpretive standards, and reasonably concluded that the language of the decree and the long-term course of performance by the parties evince an intention on the part of the Commonwealth to undertake a broad-based legal obligation from which it never dissented until the district court proceedings were about to be closed. The language of the consent decree, and the well-informed findings of the district court regarding the parties’ post-decree course of compliance with the decree, demonstrate that the Commonwealth intended, at the time the decree was approved in 1977, to submit to the jurisdiction of the United States District Court all collateral mental health facilities involved in the contemplated decentralization of mental health services previously provided at Rio Piedras. The majority’s analysis, on the other hand, seems rooted in its concern that the district court may have loosed itself from the jurisdictional constraints imposed by the language of the consent decree, armed with its own charter to regulate all public mental health facilities and patients in the Commonwealth. While there can be no doubt that such an arrogation of power would warrant firm remediation, neither the district court *1348nor the plaintiffs have interpreted the consent decree to confer any such unlimited or ambiguous jurisdictional license as the majority suggests.
The majority proceeds on the doubtful assumption that the decentralization provision operated ab initio as an unmitigated burden on the Commonwealth.28 On the contrary, the Commonwealth gained the benefits of flexibility, affording it the option either to upgrade facilities at Rio Pie-dras to accommodate its initial patient population, or to convert Rio Piedras to a downscaled facility through periodic patient transfers to alternate sites of its own choosing. Under the majority’s view, the Commonwealth would have been faced with a new lawsuit, with all its attendant litigational burdens, as to each different collateral facility to which a member of the plaintiff class was transferred. The consent decree, on the other hand, contemplated from its inception that certain as-yet unidentifiable patient services then being provided at the overcrowded Rio Pie-dras facility might no longer be offered at those premises by the time the litigation was brought to a conclusion. At the present time, Rio Piedras apparently is in compliance with the stipulations in the consent decree. Compliance was achieved, however, as understood and agreed by all concerned, only through the transfer of numerous former Rio Piedras patients to various collateral support facilities, such as the 144-bed module at Guerrero — the facility at issue on appeal. Furthermore, no other Puerto Rico mental health facility will be brought under the jurisdiction of the court in the future. Rio Piedras and its support facilities now constitute the fixed-size, decentralized form of the Hospital, and the plaintiff class includes only present and future residents of the “institution” as it is presently composed. As the district court itself noted, “persons treated in their community mental health centers who have never been patients of the Hospital, do not fall under the court’s jurisdiction.”
Under the explicit language of the consent decree, the plaintiff class is comprised of present and future “residents” of the “institution.” The jurisdiction of the district court consequently extended to Rio Piedras and all collateral facilities utilized to depopulate and decentralize Rio Piedras in order to bring it into compliance with the minimum physical standards prescribed by the consent decree. The restrictive interpretation advanced by the majority is dependent entirely on the unrealistic assumption that a significant subset of the plaintiff class, namely all patients transferred from Rio Piedras, accepted a consent decree requiring improvements at Rio Piedras but imposing no obligation on the Commonwealth regarding the quality of care available at the collateral facilities to which those same patients were to be transferred. Viewed in its litigation context, I believe that the consent decree requires the interpretation given it by the district court and that the interpretation adopted by the majority is unwarranted by either the language of the decree, the extended course of compliance and superintendence under the decree, or the nature and aims of the class action.
I. Plain Language of Consent Decree
Although federalism concerns offer an arguable basis for de novo appellate review of the jurisdictional reach of a consent decree governing public institutional reform litigation,29 the majority’s plenary *1349scanning of the plain language of the consent decree substitutes appellate interpretation of the stipulations of the parties for the interpretation of the superintending court, unconstrained even by the “ordinary contract principles” alluded to by the majority.
The proper interpretation of a consent decree basically presents a question of law, as does the preliminary determination whether the disputed language is ambiguous. See AMF, Inc. v. Jewett, 711 F.2d 1096, 1100-01 (1st Cir.1983); Massachusetts Ass’n for Retarded Citizens, Inc. v. King, 668 F.2d 602, 607 (1st Cir.1981) (citing United States v. ITT Continental Baking Co., 420 U.S. 223, 238, 95 S.Ct. 926, 935, 43 L.Ed.2d 148 (1975)); see also Fashion House, Inc. v. K Mart Corp., 892 F.2d 1076, 1083 (1st Cir.1989). The majority suggests that the terms “institution” and “Rio Piedras Hospital” were used interchangeably and synonymously throughout the decree, and that perhaps the definition of “institution” — as consisting of the “Commonwealth of Puerto Rico Psychiatric Hospital as presently constituted or in Decentralized form” — was included merely to ensure that an internally-restructured facility at Rio Piedras, or any other mental health facilities subsequently placed under the direct administrative control of the Rio Piedras Hospital, would be covered by the terms of the decree.
The massive overcrowding at the Rio Pie-dras facility in 1977 manifested to all the parties that the system of care provided at Rio Piedras in 1977 might well be “decentralized” over time. Yet the parties could not then know, with any precision, which or how many collateral mental health facilities would be needed to accommodate the patients who would have to be transferred from Rio Piedras.30 Plaintiffs contend that the definition of “institution” incorporated in the decree was deliberately phrased in broad terms because the parties needed to make express allowance for future contingencies as to what form the systemic “institution” ultimately would take. Such inherent flexibility is one of the major advantages of utilizing consent decrees in public institutional reform litigation. Thus, even assuming that we are to confine ourselves to a “four corners” interpretation of the decree, as advocated by the majority, I cannot agree that the majority has demonstrated that its interpretations of “institution” and “decentralized form” are permissible in light of the explicit language of the consent decree.
First, the majority converts the pivotal definition of “institution” into virtual sur-plusage by suggesting two implausible reasons for its inclusion in the consent decree. Because the particular array of services provided at the Rio Piedras facility was almost certain to change during the course of the Commonwealth’s compliance, the majority posits the theory that the parties included the definition of “institution” only to ensure that the stipulations in the decree would continue to apply to this internally-restructured facility. We should be very reluctant to conclude that prominent language in a decree, which has received the imprimatur of the parties and the superintending court, is superfluous and without legal import. See, e.g., Systemized of New England, Inc. v. SCM, Inc., 732 F.2d 1030, 1034 (1st Cir.1984); J.E. Faltin Motor Transp., Inc. v. Eazor Express, Inc., 273 F.2d 444, 445 (3d Cir.1960). The majority fails to explain why, if the Rio Piedras facility were to remain an intact entity at its original location, the simple phrase “Rio *1350Piedras Hospital” would not have sufficed to ensure the application of the stipulations to the restructured facility. Under the majority’s interpretation, any further elaboration of the term “institution” would have been superfluous.
The majority next suggests that the parties may have included the definition of “institution” to encompass any new branches of the Rio Piedras facility opened by the Commonwealth at other locations throughout Puerto Rico and placed under the same administrative control as Rio Pie-dras. See supra at n. 4. The suggested interpretation is totally at odds with the underlying goal of the litigation and the consent decree, which was to fix the obligations of the Commonwealth to all members of the plaintiff class. We cannot plausibly suppose that the parties would have had any reason to insert in the decree a prominent provision whose only purpose would be to govern the Commonwealth’s unilateral decision to “reshuffle” the organization within its Department of Health. After all, the Commonwealth ultimately controls all public mental health facilities in Puerto Rico, regardless of the number of discrete administrative units into which it might choose to parcel its mental health program. Given that reality, the majority fails to explain how such administrative reshuffling would even be material to the resolution of the problems to be addressed by the present litigation. By emphasizing the bureaucratic form of the Hospital, rather than the substantive goals of the litigation and the consent decree as a whole, the majority interpretation renders the Commonwealth’s obligation totally illusory. See, e.g., Shakey’s Inc. v. Covalt, 704 F.2d 426, 434 (9th Cir.1983) (preference given to contract interpretation that does not render obligations illusory). According to the majority view, the Commonwealth would be free at any time to redefine its obligations under the consent decree, artificially, by placing various facilities under the nominal control of an administrative unit of the Department of Health separate from the Rio Piedras facility. Furthermore, under the majority’s thesis, the Commonwealth would have been permitted to effect a unilateral shutdown of the entire Rio Piedras facility, transferring all its patients to other facilities, without any further obligation to former Rio Piedras patients. I believe it inappropriate to trivialize a judicial decree in this manner, particularly a consent decree.
Second, the majority emphasizes that the decree specifically describes physical conditions at the Rio Piedras facility, while omitting any description of the physical conditions at other facilities mentioned in the decree, such as the mental health programs at Cayey and Bayamon. The majority proposes to interpret the absence of such descriptions as an indication that the stipulations in the consent decree were not meant to apply to any facility other than Rio Piedras.
The significance of the asserted “omission” must be viewed in conjunction with the broad definition of “institution” set out earlier in the consent decree. It is a common drafting technique (expressio unius est exclusio alterius) to omit specific examples (Cayey and Bayamon) where their inclusion might imply that the specific examples completely exhaust the scope of a broader category previously defined. See generally 2A Norman J. Singer, Sutherland Statutory Construction §§ 47.23, 47.24 n. 6, at 194, 203, 205 (4th ed. 1984) (discussion of exclusio doctrine in interpreting statutes and contracts). The inclusion of a specific description of the physical conditions at Cayey and Bayamon might well have been considered a reasonable basis for inferring that Cayey and Bayamon comprised the entire fixed “decentralized form” of the Hospital, and that no other collateral facilities, such as Guerrero, could have been considered part of the “institution” in the future. Thus, the “omission” relied on as support for the narrower interpretation advanced by the majority provides persuasive support for the interpretation given by the district court.
Furthermore, as previously noted, the particular physical conditions at Cayey and Bayamon were not the primary or immediate focus of the consent decree. The decree requires that the Rio Piedras facility *1351be brought into compliance with the stipulations in the decree. At such time as the Commonwealth were to achieve compliance at the Rio Piedras facility, the court would be required to determine that the collateral support facilities to which Rio Piedras patients had been transferred in order to achieve compliance at Rio Piedras were also in compliance with the minimum standards stipulated in the consent decree. Conceivably, the Cayey and Bayamon facilities might not have remained as permanent parts of the “institution” if, between 1977 and 1989, the Commonwealth decided that the patients initially transferred to those facilities would be better placed in some other collateral facility. Thus, the decree envisioned that the ultimate scope of the “institution” would remain open to final definition through reference to its culminating eventuality, the achievement of full compliance with the consent decree by the Rio Piedras facility.
Third, the majority suggests that the provisions of the decree relating to the internal procedures for screening the medical requirements of incoming and transferring patients demonstrate that the terms “institution” and “Hospital” are used interchangeably by the parties. The interpretation of a pivotal provision in a consent decree should not be approached under the assumption that it is the product of poor draftsmanship or an indiscriminate use of terms. Instead, at least when the resulting interpretation fully accords with the language and context of the consent decree, it is appropriate to credit the parties with a mutual intention to use different terms to import distinctive meanings. Read in context, the language cited by the majority does not equate the terms “Hospital” and “institution.” Rather, it is clear that the screening provision prescribes distinct requirements for in ira-institutional patient transfers, namely transfers of patients between Rio Piedras and its collateral component facilities, and inier-institutional patient transfers, namely transfers of patients from outside the “institution” into Rio Piedras or one of its collateral facilities.31
Finally, the majority notes that Section B, which contains both the definition of “institution” and the list of stipulations, is prefaced by the heading “Standards to be Observed at the Psychiatric Hospital.” By equating the heading’s reference to “Psychiatric Hospital” with “Rio Piedras,” the majority suggests that the parties would have used the term “institution” or “covered facilities” in the heading if they had intended to apply the stipulations to facilities other than Rio Piedras, which constituted the entire psychiatric hospital at the time of the decree.
*1352Contrary to the majority’s contention, heading “B” refers generically to the “Psychiatric Hospital,” and not to the “San Juan Psychiatric Hospital,” the term reserved elsewhere in the decree to denote the Rio Piedras facility. If indicative at all, heading “B” merely suggests that the parties contemplated, at the time of the decree, a basic hospital structure different than the one then existing at Rio Piedras. Moreover, a cardinal rule of contract interpretation requires that no individual provision, even a heading, be interpreted in isolation from its context within the document as a whole. See Spartan Industries v. John Pilling Shoe, 385 F.2d 495, 499 (1st Cir.1967); cf. United States v. Roemer, 514 F.2d 1377, 1380 (2d Cir.1975) (rule of statutory construction gives precedence to detailed text over generalized headings). The definition of “institution” is the first substantive provision following heading “B,” a prominence further emphasized by the fact that the lengthy list of definitions of which it is part is not arranged alphabetically. It seems almost certain that the only reasonable justification for placing the definition of “institution” in section B was to define the coverage and reach of the stipulations contained in the very same section. This definition makes clear that the form of the hospital at the time of the consent decree (i.e., Rio Piedras) might not be determinative of the scope of the stipulations should the Hospital ultimately decentralize its services.
The district court interpretation ascribes meaningful import to the disputed language, consistent with the overall purposes of the other provisions of the consent decree. The majority has not demonstrated that the decree is ambiguous, so as to warrant an alternative interpretation of the terms “institution” and “decentralized form.”
II. Ambiguity and Extrinsic Evidence of Intent
Assuming, arguendo, that the disputed terms of the decree are ambiguous, however, I cannot agree that the district court interpretation is not due considerable deference. The majority asserts that our normal deferential stance toward district court interpretations in public institutional reform litigation is inappropriate when the disputed language in the consent decree involves the important question of jurisdiction, rather than mere modes of compliance with the terms of the decree. If an ambiguous decree must be interpreted as any other contract, however, the majority does not explain why the district court cannot be permitted to employ “ordinary contract principles” which look beyond the confines of the “four corners” of the contract or decree to determine the true intent underlying the parties’ use of the disputed language. Our customary “deference” to the trial court in every other case of contract interpretation is based on the recognition that the trial court is better situated to appraise the probative value of this type of extrinsic evidence. I believe that the majority opinion not only unnecessarily restricts the interpretive inquiry to the “four corners” of the consent decree, but discards appropriate interpretive tools for discovering the intent of the parties as expressed in their consent decree and undervalues the district court’s superior opportunity to evaluate the pertinent extrinsic evidence developed during the course of its superintendence of public institutional reform litigation.32
*1353I cannot agree that the district court improperly relied on the parties’ post-decree conduct either to “revise” retrospectively the terms of the decree or to deprive the Commonwealth of its original bargain. Concededly, although the court was at all times acutely mindful of the parties’ understanding of the scope of the decree, its opinion does not contain a detailed analysis of the language of the decree.33 Instead, the district court chose not to base its decision on the ground that the phrase “decentralized form” was unambiguous as a matter of law. Assuming some latent ambiguity, the court opted to examine extrinsic evidence to determine the intent underlying the jurisdictional provisions in the consent decree.
In earlier cases treating the proper interpretation of an ambiguous consent decree, the Supreme Court implicitly confined the proper focus to the “four corners” of the decree, abjuring recourse to extrinsic evidence. See United States v. Armour & Co., 402 U.S. 673, 681-82, 91 S.Ct. 1752, 1757-58, 29 L.Ed.2d 256 (1971). In later caselaw, however, the Supreme Court disparaged such a narrow reading of Armour:
Since a consent decree or order is to be construed for enforcement purposes basically as a contract, reliance upon certain aids to construction is proper, as with any other contract. Such aids include the circumstances surrounding the formation of the consent order, any technical meaning words used may have had to the parties, and any other documents expressly incorporated in the decree. Such reliance does not in any way depart from the “four corners” rule of Armour.
United States v. ITT Continental Baking Co., 420 U.S. 223, 238, 95 S.Ct. 926, 935, 43 L.Ed.2d 148 (1975) (emphasis added). As noted, this type of “extrinsic evidence” analysis does not seek to modify the terms of the original consent decree without the parties’ consent. Rather, as with all other methods of contract interpretation, the court may use extrinsic evidence to discover the original intent of the parties in settling upon the particular language used in the consent decree. See, e.g., Raymond Keith Foster, Keith Foster Mfg. Co. v. Hallco Mfg. Co., 947 F.2d 469, 482 (Fed.Cir.1991); United States v. O’Rourke, 943 F.2d 180, 187 (2d Cir.1991); North Shore Labs. Corp. v. Cohen, 721 F.2d 514, 519, 520 n. 5 (5th Cir.1983).
Under a well-established rule of contract interpretation, the court may look to the parties’ post-contract course of conduct and performance to ascertain the “practical interpretation and application” that the parties themselves attached to ambiguous contract language:
In the process of interpretation of the terms of a contract, the court can frequently get great assistance from the interpreting statements made by the parties themselves or from their conduct in rendering or in receiving performance under it. ... The process of practical interpretation and application, however, is not regarded by the parties as a remaking of the contract; nor do the courts so regard it. Instead, it is merely a further expression by the parties of the meaning that they give and have given to the terms of their contract previously made. There is no good rea*1354son why the courts should not give great weight to these further expressions by the parties, in view of the fact that they still have the same freedom of contract that they had originally. In cases so numerous as to be impossible of full citation here, the courts have held that evidence of practical interpretation and construction by the parties is admissible to aid in choosing the meaning to which legal effect will be given. Oral testimony is admissible and frequently is absolutely necessary, even in cases where the terms are fully “integrated” in writing, to demonstrate the application of the terms to the property, persons, and events to which they are related. The parties may employ language the application of which they know to be uncertain and to which they are too indifferent at the time of executing the contract to take the trouble to make certain. This does not prevent the existence of a valid contract; but it causes much greater dependence to be put upon their subsequent practical interpretation and construction.
3 Arthur L. Corbin, Corbin on Contracts § 558, at 249-253 (1960) (emphasis added). Through the performance rendered by the parties, the court gains invaluable insight into the practical interpretation mutually intended by the contract language. See, e.g., U.S.I. Properties Corp. v. M.D. Constr. Co., Inc., 860 F.2d 1, 10 (1st Cir.1988), cert. denied, 490 U.S. 1065, 109 S.Ct. 2064, 104 L.Ed.2d 629 (1988).
Unlike a simple contract action where the post-contract conduct of the parties usually must be presented to the court in the form of controverted extrinsic evidence, much relevant post-consent decree conduct in public institution reform litigation takes place before the district court in the course of its ongoing superintendence of the performance required under the decree. During the required performance, the district court is uniquely positioned to evaluate typical modes of expression by the parties and the significance of their silence or acquiescence in the face of representations by the court and the conduct and representations of opposing parties. It seems most appropriate that district court findings based on extrinsic evidence should be reviewed for clear error only. See, e.g., Fox v. United States Dept. of Hous. & Urban Dev., 680 F.2d 315, 319 (3d Cir.1982) (resort to use of extrinsic evidence in interpretation of consent decree converts issue to one of fact). Thus, it seems particularly inappropriate in the present context to deny deference to the district court’s interpretation of the consent decree.
The record provides overwhelming support for the district court findings in this case. The court found that the Commonwealth, by its course of compliance over a period of twelve years, indicated that it intended to accede to district court jurisdiction over any support facilities needed to decentralize services previously administered on the Rio Piedras premises. The court based its findings on several factors.
First, the court noted that in several reports made prior to the Secretary of Health’s submission of Plan 3, the Special Master repeatedly emphasized “the systemic approach to securing compliance [with the decree].”34 In fact, immediately prior to the submission of Plan 3, the Secretary provided the Master with budgetary information that covered the entire public mental health network in Puerto Rico. The Master responded with a letter, stating that
the report’s budgetary information is apparently based on a misconception of *1355the scope of the Court’s jurisdiction. The Court’s authority does not encompass the entire mental health system of Puerto Rico, but only the following: the Rio Piedras Psychiatric Hospital, pre-hos-pital facilities such as mental health centers and out-patient clinics which service patients who otherwise would be treated by the Hospital, and post-hospital transitional and related services which receive the Hospital’s discharged patients.
Thus, the district court reasonably found that Plan 3 contained a commitment by the Commonwealth to “deinstitutionalize” the Hospital, which included the later transfer of patients to Guerrero.
Second, while the Commonwealth contends that it immediately filed a timely objection to the scope of the district court’s jurisdiction as proposed by the Secretary in Plan 3, its so-called “objection” merely challenged the possible extension of the court’s jurisdiction to every public mental health facility in Puerto Rico. Moreover, the Commonwealth’s own exception continued to treat the “institution” as including both Rio Piedras and its support facilities.35 Unquestionably, the district court appropriately treated the Commonwealth’s “objection” as strong extrinsic evidence that the Commonwealth itself intended that the consent decree cover Rio Pie-dras and whatever facilities were used to decentralize the care of Rio Piedras patients.
Third, when the district court finally entered its order incorporating Plan 3, thereby defining its jurisdiction to include Rio Piedras’ support facilities generally and Guerrero specifically, the Commonwealth neither objected nor appealed. This telltale silence on the part of the Commonwealth further reinforced the district court’s reading of the Commonwealth “objection” to Plan 3 as an objection to any extension of jurisdiction to all mental health facilities in the Commonwealth, and not as a challenge to district court jurisdiction over Rio Pie-dras and its decentralized support system.36
*1356Finally, the district court noted that the Commonwealth continued to allow tripartite evaluation visits to these transitional facilities after 1987, clearly indicating that the physical conditions at these facilities would be material to the issue of full Commonwealth compliance with the consent decree.37 The majority dismisses these tripartite visits by concluding that they were “undertaken for the limited purpose of ‘evaluat[ing] if transferred patients were better off than if they remained in the hospital.’ ” (emphasis added). Assuming, arguendo, that the district court possessed only the very limited authority to compel transfers out of Rio Piedras solely to ensure compliance with the stipulations at Rio Piedras, the majority offers no explanation for the Commonwealth’s acquiescence to any such comparative study of conditions at the collateral facilities. The only conceivable purpose to be served by such a comparative study would have been to ensure that the minimum conditions prescribed in the stipulations were being applied throughout the “institution.”
Since the case simply has not been made that the district court’s findings are clearly
erroneous, and its findings comport with a reasonable interpretation of “decentralized form,” I believe we are required to defer to the district court’s “intimate understanding of the history and circumstances of the litigation,” United States v. Commonwealth of Massachusetts, 890 F.2d 507, 510 (1st Cir.1989), especially in a case where there can be no doubt that the district court engaged in a sensitive analysis of the principles of federalism implicated by its decision. Therefore, although I concur in Part I of the majority opinion, I must respectfully dissent from Part II.

. The district court devoted twelve pages of its forty-nine page opinion to a reasoned discussion of the Commonwealth’s federalism claims.

. The majority concludes that the district court had the authority to compel the Commonwealth to transfer patients from Rio Piedras, but had no jurisdiction to require that the quality of the treatment provided to transferred patients at the collateral facilities would conform to the stipulations in the consent decree. Thus, ironically, the majority would give the district court more authority over the Commonwealth than it would have under plaintiffs’ interpretation, which would leave the Commonwealth with the unfettered right to determine for itself whether to achieve compliance through on-premises improvements or patient transfers, or, as the defendants in fact elected to do, by a combination of means.

. The majority posits the theory that federalism concerns are heightened when a federal court purports to interpret a provision defining the number of institutions with respect to which a State accedes to the exercise of federal court *1349jurisdiction, but not when the federal court defines the "details” of the implementation of a particular policy set out in a decree. The reality is, however, that a federal court’s definition of the physical reach of its jurisdiction may pose less unforeseen burdens on the State than may result from the broad brush policy implementation permitted by the majority.

. The majority asserts that plaintiffs’ proposed interpretation of "decentralized form” is far broader than the definition of the remedy demanded in the complaint. This assertion overlooks the dynamic of the negotiation process that typically follows the commencement of public institutional reform litigation. Moreover, at the outset the plaintiffs were seeking to correct conditions at the hospital, but could not be expected to outline in their complaint the particular means the Commonwealth would elect or be required to utilize to bring about the necessary improvements.

. The first sentence provides that "Mental Health Centers which refer patients to the San Juan Psychiatric Hospital shall make a preliminary evaluation of the mental condition of such patient.” This provision ensures that non-acute patients will no longer be transferred to the Rio Piedras facility from other collateral facilities of the "institution” unless they need the type of intensive care provided at Rio Piedras.
The second sentence, broader in scope, provides that "[e]ach patient who is referred to the institution must be preliminarily evaluated by the Emergency Room Physician prior to admission to determine whether he should be admitted.” Under this provision, if a patient is transferred into the "institution,” as defined in the decree, from any facility outside the institution, the patient must be evaluated at Rio Piedras to ensure that he is placed in the appropriate component facility (pre-hospital facility, hospital facility, post-hospital facility), or that he is denied admission if he will not benefit from any of these treatment programs.
The third sentence provides that “[i]f admitted, within two weeks days [sic] of his or her admission to the institution each patient is to be evaluated by the physician assigned to the ward where the patient has been placed.” This provision merely requires that the institution place admitted patients in appropriate “wards” within a particular component facility. It is designed to prevent repetition of the problems previously encountered at Rio Piedras where patients often were grouped together "according to their geographical origin, regardless of their mental condition and needs.” The term "ward,” which is not defined in the decree, certainly is not so precise or exclusive that it could only refer to sections or divisions at the Rio Piedras facility. Presumably, other collateral facilities of the "institution” might segregate patients into different sections according to their medical needs. For example, the Guerrero facility apparently is divided into modules containing fixed numbers of patients and beds, since a 144-bed module has been set aside to receive patients transferred from Rio Piedras.

. We consistently have held that its more direct exposure to public institutional reform litigation entitles the district court to considerable deference, even in cases where the particular district court judge whose ruling is before us on appeal is not the judge who approved the original consent decree:
Appellants argue that deference is not warranted here because the ... decrees were entered by one judge, and three other judges have presided over this case. Furthermore appellants argue, the trial judge was “entirely uninvolved" in the case until the eve of trial. This argument is without substance. It is the district court as an institution that merits deference. We are unwilling to develop a litmus test for use in analyzing the depth of a trial judge’s familiarity with a case in order to determine the resulting deference to which he or she is entitled.
Pearson v. Fair, 935 F.2d 401, 409 (1st Cir.1991) (emphasis added); see also Langton v. Johnston, 928 F.2d 1206, 1222 (1st Cir.1991) (“The district court, albeit in the person of a series of [five] *1353different judges, has been the central figure in monitoring the extent and adequacy of services provided at the Treatment Center over the better part of the last two decades.”).

. The district court opinion did note, however:
Plaintiffs claim that the term "in decentralized form” demonstrates that the parties understood, when they negotiated the stipulated agreement, that the Hospital might in the future be decentralized by relocating its pre and post hospital services, that this process was in fact begun and is continuing under Plan 3, and that the parties intended from the beginning that Hospital patients decentralized or deinstitutionalized would continue to be members of the Class covered by the stipulations. The Court considers plaintiffs’ interpretation of the parties’ intent to have considerable merit, but finds no need to rely on it in view of the analysis which is fully developed in this opinion of the acceptance by the parties since 1985, until October 1989, that the Hospital’s full compliance depended on a systemic approach, covering not only the services it rendered directly, but as well its support system of pre and post hospital services.
(Emphasis added.)

. In his third report filed in 1986, the Master described the Commonwealth's recent evaluation of a “model" mental health program in Boston (the Massachusetts Mental Health Center), which consisted of “a complex of intensive care units, a day-hospital, an inn and an array of residential facilities scattered throughout the community designed to satisfy the needs of the individual patient." The Master concluded that the Massachusetts model "can be incorporated into the Hospital’s plan to comply with the consent decree.” The Master also stated that the Commonwealth's budget for fiscal year 1986-87 "was entirely inadequate to bring the Hospital and its supporting mental health services into compliance with the consent decree," and again, later in that report, stated that "[alt that budgetary level neither the Hospital nor the mental health programs on which it must rely could possibly come into compliance.”

. The Commonwealth’s exception to Plan 3’s jurisdictional provisions states, in pertinent part:
Said plan includes a description of the Mental Health Program of the Commonwealth of Puerto Rico to illustrate this Honorable Court and the Master as to the scope of the program. The Psychiatric Hospital of Rio Piedras is only a part of said program and is the institution under the stipulations before this Honorable Court, with whatever facilities may be used to descentralize [sic] the care of said hospital’s patients. As before stated the individuals that come in contact with the primary units of the mental health program are not patients of the Psychiatric Hospital and most of the time do not become so. The class in the present action is composed of the patients of the Psychiatric Hospital and the institutions wherever they may be referred to in a descen-tralization [sic]program * [*See definitions of the stipulations — June 27, 1987] Defendants respectfully reiterate their request to maintain the scope of the class in the above captioned case and the stipulations agreed on by admitting from Plan # 3 those portions that apply to the Psychiatric Hospital.
Despite the Commonwealth’s clear reference to the definition of the term "institution," the majority concludes that the reference was later contradicted and limited by the Commonwealth’s final request that the court "admit[ ] from Plan 3 those portions [of the jurisdictional provisions] that apply to the psychiatric hospital." The word "admit” refers to the impending order of August 10, 1987, in which the district court would either admit or reject the individual provisions proposed in Plan 3. The objection demonstrates that the defendants would not challenge the inclusion of Plan 3’s jurisdictional provisions if interpreted so as to include only the “psychiatric hospital," therein defined by the Commonwealth, in perfect agreement with the language of the consent decree, as “the institution ... with whatever facilities may be used to decentralize the care of said hospital’s patients.”
Finally, the majority states that the district court, in its order of August 10, 1987, interpreted the Commonwealth’s challenge as an objection to the expansion of the court’s jurisdiction beyond Rio Piedras, rather than as a narrower objection to an extension of jurisdiction beyond the "institution” to all mental health facilities in Puerto Rico. After generally noting that the Commonwealth had never before questioned the scope of the court’s jurisdiction as opined by the Master, the district court merely concluded that the defendants had "waived whatever claim that they might have had about ... the scope of the stipulations.” The court decided that defendants could raise no jurisdictional objection of any kind at that late stage of the litigation, and it never addressed the nature of the jurisdictional “objection” advanced in the exception.

. In rejecting the plaintiffs equitable estoppel argument, the majority states that the transferred patients did not rely to their detriment on the Commonwealth’s acquiescence or its repre*1356sentations regarding the court’s jurisdiction. On the contrary, transferred patients, as members of the plaintiff class, were contracting parties for purposes of the consent decree and must be deemed to have relied on the definition of "institution” contained in the consent decree. If patients who were to be transferred had been alerted that, once transferred from Rio Piedras, they would be beyond the reach of the district court’s equitable powers, the plaintiff class could have prevented the Commonwealth from transferring them from Rio Piedras, thereby keeping them under the protection of the decree. Once their reasonable reliance on the Commonwealth’s course of compliance with the consent decree caused transferred patients to become stranded beyond the district court’s equitable powers, transferred patients inarguably suffered a legal detriment of significant proportions under the jurisdictional interpretation adopted by the majority.

. There is no inequity in using the post-decree acquiescence or the practical interpretation of the consent decree by successive officials of the Commonwealth to determine the original intent of the consent decree. The general rule that one administration cannot bind its successors by its stated positions does not apply to government officials in the context of public institutional reform litigation. See Fed.R.Civ.P. 25(d); see also Newman v. Graddick, 740 F.2d 1513, 1517-18 (11th Cir.1984) (current state officials have authority to enter into consent decree and bind incoming successors, who upon taking office become parties to decree through automatic substitution) (citing United States v. Swift, 286 U.S. 106, 52 S.Ct. 460, 76 L.Ed. 999 (1932)). The practical interpretation given the original terms of the consent decree by each successive Commonwealth administration, as a substituted party to the proceedings, bears directly on our inquiry into the meaning of the consent decree.