Prisma Health-Upstate signed an asset purchase agreement to acquire KershawHealth Medical Center and Providence Hospitals from Legacy LifePoint Health, Inc. on March 5, 2020. Under the terms of agreement, KershawHealth, Providence Health and Providence Health Northeast, and a freestanding emergency room in Fairfield County would be added to Prisma Health-Midlands. On February 28, 2020, South Carolina Department of Health and Environmental Control (DHEC) updated the Certificate of Public Advantage (COPA) Agreement Conditions, which was issued to Prisma Health-Midlands in 1997, to address the addition of the /Providence Hospitals and KershawHealth assets. The completion of the acquisition is pending the fulfillment of customary legal and regulatory requirements. Prisma Health-Upstate terminated an asset purchase agreement to acquire KershawHealth Medical Center and Providence Hospitals from Legacy LifePoint Health, Inc. on April 09, 2021. The deal was plagued by legal challenges, Federal Trade Commission and state regulatory authorities have made it prohibitive to move forward. It was Prisma and Providence's competitor, Lexington Medical, that filed suit in S.C. Administrative Law Court, attempting to block the sale by alleging state regulators did not give it a proper review.