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Court rules vets home lawsuit can go forward

The residents of the Armed Forces Retirement Home in the nation’s capital got an early shot of holiday cheer Friday: the possibility of better medical care sometime down the road.

The U.S. Court of Appeals for the District of Columbia Circuit reversed a lower-court ruling that dismissed a class-action lawsuit filed by residents over the quality of medical care provided at the home. The reversal means that the suit will go forward in the lower court.

In 2005, residents of the home sued the chief operating officer and the secretary of defense, asking for an injunction to compel the home to provide a primary treatment room staffed by an on-location physician and primary health care for residents 24 hours a day, seven days a week.

It also asked that the home be able to provide “the medications required for the treatment of residents ... X-ray, electrocardiogram, lab work and other services”; annual physical and mental exams; and other services, such as transportation.

The suit was aimed at countering several 2003 cost-saving measures that residents say eroded available health care on the 272-acre campus. The cutbacks allegedly included the unavailability of physicians and dentists, neglect of patients and delays in obtaining prescription drugs.

After the suit was filed, Congress subsequently made two small changes in law mandating improved care at the home.

The lower court agreed with the government that those changes rendered the residents’ suit “moot.” But the appeals court ruled that if the lower court’s interpretation was left to stand, the home’s chief operating officer essentially would have the power to decide to provide no physical exams at all, since such exams are not specified in the changes Congress made. Similarly, the appeals court said, the COO could hire just a single physician to serve all 1,000 residents, because the new rules technically called only for “a physician” be available.

The changes in the wording of the law, the appeals court ruled, do not, on their own, fully satisfy the home’s original mandate to “provide for the overall health care needs of residents in a high-quality and cost-effective manner, including on-site primary care, medical care and a continuum of long-term care services.”

The government’s case against the residents rested on a technicality: that the mandate was exempt from judicial review because federal law gave the COO wide discretion to decide how that mandate should be met.

The appeals court rejected that argument. The lower court, the U.S. District Court for the District of Columbia, will now consider the issue of whether the residents are getting health care at a level mandated by law and, if not, what relief can be given to them. It is unclear when the district court might take up the case again.

Until a few years ago, there were two Armed Forces Retirement Homes —one in Washington and another in Gulfport, Miss. The latter was destroyed in 2005 by hurricanes Katrina and Rita. Plans are in the works to rebuild it by 2010.

To be eligible to live in the AFRH, veterans must have served at least half of their time in uniform as enlisted members, warrant officers or limited-duty officers, and fit one of these categories:

• Veterans with 20 or more years of active-duty service who are at least 60 years old.

• Veterans unable to earn a livelihood due to a service-connected disability.

• Veterans unable to earn a livelihood due to injuries, disease or disability, and who served in a war theater or received hostile-fire pay.

• Female veterans who served prior to 1948.

Residents also must be able to live independently at the time of admission. If increased health care is needed at some point after admittance, assisted living and long-term care is available.