Tri-isthmus Group, Inc. (TIGroup), invests in and provides financial and managerial services to healthcare facilities in non-urban markets. It promotes medical care by offering access and breadth of services. The Company has provided companies with business process outsourcing (BPO). In November 2004, the Company has sold its BPO operations in Asia. During the year ended September 30, 2008 (fiscal 2008), the Company acquired 51% of Rural Hospital Acquisition, LLC (RHA). The Company focuses in serving as a guarantor in the event RHA defaults on the cash payments or the promissory note. During fiscal 2008, RHA purchased 100% of Southern Plains Medical Center (SPMC).