Belhaven Senior Care, LLC, Trend Consultants, LLC, and C. Bruce Kelly v. Betty Smith, Individually, and as Administratrix of the Estate of Mary Hayes, and on behalf of and for the use and benefit of the Wrongful Death Beneficiaries of Mary Hayes, 359 So.3d 612

91-year-old Mary Hayes was admitted to Belhaven Senior Care on November 7, 2018; her daughter Betty Smith signed the facility’s admission agreement, which contained an arbitration clause.
A nurse practitioner signed the admission physician orders; a physician (Dr. Timothy Estes) first evaluated Hayes 11 days after admission.
Hayes had dementia and was described as “cognition impaired,” but there is no physician finding in the record that she lacked capacity at admission or thereafter.
Smith sued Belhaven (individually, as administratrix, and for wrongful-death beneficiaries) for negligence and related tort claims arising from Hayes’s residency; Belhaven moved to compel arbitration.
The trial court denied the motion to compel arbitration; the Mississippi Supreme Court affirmed, holding Belhaven failed to prove Smith had statutory surrogate authority and that doctrines like direct-benefit estoppel or third‑party beneficiary status bound Hayes to arbitration.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Smith had authority under the Health-Care Decisions Act to bind Hayes to arbitration (statutory surrogate)	Smith: no primary physician determined Hayes lacked capacity when Smith signed the agreement, so she lacked surrogate authority	Belhaven: Smith acted as statutory healthcare surrogate and could waive arbitration on Hayes’s behalf	Court: Belhaven failed to rebut statutory presumption of capacity; no evidence a primary physician determined incapacity or undertook primary responsibility at admission; surrogate authority not proved
Whether direct-benefit estoppel prevents Smith from denying the arbitration clause	Smith: Hayes (allegedly incapacitated) did not knowingly seek/obtain benefits and Smith’s tort claims do not enforce the contract	Belhaven: Hayes/Smith embraced the contract and benefited, so estoppel should apply	Court: Estoppel inapplicable—incapacitated person cannot knowingly seek benefits and tort/ negligence claims do not require enforcing contract terms
Whether Hayes was a third-party beneficiary of the admission agreement and thus bound	Smith: No valid contract existed because Smith lacked authority to bind Hayes; therefore Hayes cannot be a third-party beneficiary	Belhaven: Hayes was a third-party beneficiary and cannot contest the agreement	Court: No valid contract (because no surrogate authority), so no third-party beneficiary status

Hattiesburg Health & Rehab Ctr., LLC v. Brown, 176 So. 3d 17 (Miss. 2015) (incapacitated resident cannot knowingly seek benefits; limits on estoppel)
Adams Cmty. Care Ctr., LLC v. Reed, 37 So. 3d 1155 (Miss. 2010) (FAA applies to nursing-home admission arbitration clauses; presumption of capacity rule)
Tarvin v. CLC of Jackson, LLC, 193 So. 3d 633 (Miss. 2016) (strict interpretation of the Health-Care Decisions Act)
Grenada Living Ctr., LLC v. Coleman, 961 So. 2d 33 (Miss. 2007) (elements of a valid contract)
Scruggs v. Wyatt, 60 So. 3d 758 (Miss. 2011) (standard for direct-benefit estoppel by non-signatories)
KPMG, LLP v. Singing River Health Sys., 283 So. 3d 662 (Miss. 2019) (burden on party invoking arbitration to prove agreement exists)
Mitsubishi Motors Corp. v. Soler Chrysler-Plymouth, Inc., 473 U.S. 614 (1985) (arbitration inquiry includes legal constraints external to the agreement)