Despite laying off clinical staff at Summerville Medical Center three months ago, Trident Health System won state approval Wednesday to build a $27 million, 30-bed expansion at the facility.

Trident's victory, however, might be short-lived. The hospital system's competitor, Roper St. Francis Healthcare, will fight the approval in the coming week, a Roper official said.

Trident, owned by national hospital chain HCA Inc., applied in November to build a three-story "patient tower" at its existing 94-bed Summerville facility.

"The project will increase accessibility and availability of acute care services to the residents of Charleston, Berkeley and Dorchester counties," an official from the S.C. Department of Health and Environmental Control wrote in a letter to Trident on

Wednesday. "The applicant has demonstrated this project to be financially feasible."

The state said changing 18 shared rooms to private ones during the expansion would "increase the standard of care" for patients by reducing the spread of infection.

Roper has opposed the expansion, publicly lodging its complaints in a June letter to the state. Roper officials said Trident hasn't proven it needs the additional beds in Dorchester County. They said any new expansion could impair future operations at two planned hospitals in neighboring Berkeley County.

Roper now will ask DHEC's board to review and reconsider Wednesday's staff decision, said Douglas Bowling, the Roper system's vice president and chief strategy officer.

The expansion, which will take about three years to complete, is expected to result in 50 new jobs at the Summerville facility, Trident officials said. In June, Trident Health System laid off 35 full-time workers at its North Charleston and Summerville facilities to cope with Medicaid cuts.

Louis Caputo, CEO of the Summerville facility, said there is "no relation between the layoffs and this project."

In a statement, Trident was unwavering about current demand for its services: "The state's decision reinforces the immediate need for additional hospital beds in the Summerville and Dorchester County community."

Caputo was more reserved.

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"If we didn't act today to add capacity, in five years we'd have a critical situation," he said.

The expansion dispute is the latest fight in an ongoing legal battle between Trident Health System -- which includes Moncks Corner, Trident and Summerville medical centers -- and the nonprofit Roper St. Francis Healthcare. The wrangling began with a battle over which system should be allowed to build a new 50-bed hospital in Berkeley County. The state approved proposals from both Trident and Roper in June 2009.

Later that year, Trident appealed Roper's approval. Officials from Trident, which filed its application with the state first, have said the area can support only one hospital.

Roper then counter-appealed, saying both systems should be allowed to build.

The location of the Summerville expansion approved Wednesday is about halfway between Roper's existing Bon Secours St. Francis Hospital West Ashley and the site of its proposed 50-bed facility near Goose Creek. Trident's proposed hospital is farther North, at the site of its existing Moncks Corner facility.

The hospital dispute is scheduled to go to trial in January.