BLUFFTON — A local state senator called it "gamesmanship." The chief executive of a competing hospital said the developments were "very frustrating." Two weeks after a Lowcountry provider dropped plans to build a new hospital due to a lawsuit, one of the opponents proposed its own plans to create a new facility nearby.

On Sept. 10, Beaufort Memorial Hospital withdrew its application to open a 20-bed facility, succumbing to a lawsuit backed by North Carolina-based giant Novant Health. More than two weeks later, Novant unveiled plans to open a 50-bed facility in Bluffton.

In a Sept. 26 news release, the nonprofit said it plans to expand the hospital to 100 beds in the future. The twin announcements continue the saga to expand health care access in Bluffton that has dragged on more than six years, intersected with a major legislative change, and legal challenges.

Novant now must navigate South Carolina's certification process, which could take years if they face legal opposition. Asked whether Beaufort Memorial would challenge Novant's application to open the facility, Chief Executive Officer Russell Baxley said the hospital is "looking at all of our options on the table at this point in time." Beaufort Memorial initially announced plans to open a Bluffton hospital in 2018.

The state health department approved its application to open the facility in July 2018, awarding a Certificate of Need for the $45 million project. While these certificates were designed to keep medical exp.