329 So.3d 563
Miss. Ct. App.2021Background
- On May 23, 2012 Alta Humphrey signed Tunica County Health & Rehab’s nursing‑home admission agreement as the resident’s “Responsible Party” and indicated authority as an "Authorized Agent and/or Health Care Surrogate." The agreement contained a broad arbitration clause.
- Dr. Richard Waller (an owner and the facility’s medical director) signed a contemporaneous physician statement stating Leroy Humphrey “is unable to sign Nursing Home admission papers due to dementia and confusion” and is listed in multiple admission forms as Leroy’s physician/attending physician.
- There is no evidence Alta held power of attorney or was court‑appointed guardian for Leroy.
- Leroy was assaulted while a resident in 2016; Bobby Humphrey, as administrator of Leroy’s estate, sued the facility in 2018 for negligence and related claims.
- The facility moved to compel arbitration; the trial court granted the motion. The central legal question on appeal was whether Alta was a statutorily authorized health‑care surrogate under Miss. Code Ann. § 41‑41‑211(1), which requires that the patient’s “primary physician” determine lack of capacity.
- The Court of Appeals affirmed, holding that although Dr. Waller was not shown to be “designated” as Leroy’s primary physician, the contemporaneous admission documents established that he had “undertaken the responsibility” and therefore qualified as the primary physician for purposes of the statute, making Alta a valid surrogate who could bind Leroy to arbitration.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Alta was a statutorily authorized health‑care surrogate able to bind Leroy to arbitration | Estate: Alta lacked surrogate authority because Dr. Waller was not Leroy’s “primary physician” when he determined incapacity, so Alta could not validly execute the admission agreement | Facility: Dr. Waller made the incapacity determination and was Leroy’s primary physician (by undertaking responsibility), so Alta validly served as surrogate and bound Leroy to arbitration | Court: Alta qualified as surrogate because Dr. Waller was Leroy’s primary physician under the statute’s second test (physician who undertakes responsibility); arbitration enforced |
| Whether a physician must be previously designated or may be a primary physician by "undertaking" responsibility at admission | Estate: The statute and caselaw require a preexisting designation or relationship; a contemporaneous evaluation is insufficient | Facility: In absence of prior designation, a physician may become the primary physician by undertaking responsibility contemporaneous with admission, as the statute’s present tense contemplates | Court: Agreed designation test not met here, but held the statute allows a physician to “undertake” responsibility contemporaneously and the records showed Waller undertook responsibility |
| Whether contemporaneous admission documents and a physician’s signed incapacity statement suffice to prove the undertaking and the required capacity determination | Estate: The contemporaneous forms are insufficient proof; facility failed its burden and should have submitted direct affidavit/testimony | Facility: The admission forms, Waller’s signed incapacity certification, Medicaid PAS signature, and other notes together prove he undertook responsibility and made the capacity determination | Court: Contemporaneous physician‑signed documents were sufficient to show Waller undertook responsibility and made the requisite determination; dissents disagreed, citing burden and lack of sworn testimony |
Key Cases Cited
- Tarvin v. CLC of Jackson LLC, 193 So. 3d 633 (Miss. 2016) (strict statutory interpretation: primary physician must determine lack of capacity)
- Adams Cmty. Care Ctr. LLC v. Reed, 37 So. 3d 1155 (Miss. 2010) (surrogate authority depends on primary physician’s capacity determination)
- Wellness Inc. v. Pearl River Cnty. Hosp., 178 So. 3d 1287 (Miss. 2015) (party seeking arbitration bears burden to establish validity)
- Virgil v. Sw. Miss. Elec. Power Ass’n, 296 So. 3d 53 (Miss. 2020) (standard of review for orders compelling arbitration)
- KPMG LLP v. Singing River Health Sys., 283 So. 3d 662 (Miss. 2018) (burden to prove existence of arbitration agreement rests with party invoking it)
- Est. of Bankston v. CLC of Biloxi LLC, 240 So. 3d 456 (Miss. Ct. App. 2017) (medical records alone are not equivalent to an affirmative physician determination of incapacity)
- Miss. Care Ctr. of Greenville LLC v. Hinyub, 975 So. 2d 211 (Miss. 2008) (admission decisions, including arbitration clauses, can be health‑care decisions)