Allowable Investments Search Tool

Identifying allowable investments for a SHIP-eligible hospital does not have to be a daunting task! This search tool created by SHIP-TA through the Federal Office of Rural Health Policy helps state coordinators and hospitals navigate the possibilities.
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54 results found

ACO Fees

Allowable
Accountable Care Organization (ACO)

Updated January 2023

ACO costs are an allowable investment under the ACO category. The hospital should identify how they will define progress to align with the state office’s SHIP goals.

Allowable investment

Alterations and Renovations (A&R)

Unallowable

Updated January 2023

Changes, additions, or demolition to hospital facilities (internal and external) are an unallowable expense. This includes alterations and renovations that may improve a SHIP category area such as patient safety. 

Some unallowable expenses include but are not limited to: 

Removing Walls Adding Walls Doorway additions/removals
Firebreaks Carpet Replacement Counter Replacement
Tile Replacement Window Additions/Replacement Restroom Upgrades/Fixes
Fixture Installation Hardwired Internet Installation Footage Increases/Decreases
Sidewalk Installation/Repair Sidewalk Upgrades Parking Lot Maintenance
Landscaping Accessibility Additions/Changes Drainage
Covered Walkways Directional Signage Roofing Upgrades/Fixes
HVAC Upgrades/Fixes Sprinkler Systems  

 

Unallowable investment

Certification (Definition)

Definition

Certification is defined as achieving benchmark outcomes (such as passing a test or inspection) in support of the desired skill, upgrade, or acknowledgment and is utilized in a manner to increase the value (or perception) of a person, business, or program. Certifications and associated costs are unallowable.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Conferences

PO Pre-Approval
Accountable Care Organization (ACO)
Payment Bundling (PB)/Prospective Payment System (PPS)
Value-Based Purchasing (VBP) Investment

Updated September 2023

Conferences may be allowable for hospital staff if most of the training sessions are within SHIP allowable investment categories. Costs for CMEs or CEUs or travel associated with the conference are unallowable. Project Officer approval is required for attendance. Please email the conference agenda along with session titles and corresponding SHIP categories to your Project Officer and ship-ta@ruralcenter.org.

Requires project officer pre-approval.

Consulting (Definition)

Definition

Consulting is defined as the hiring or contracting of a vendor or person to provide non-guaranteed guidance on a specific subject, area, program, or activity and is an unallowable expense. SHIP-approved training given by a person or business going by the title of "consultant" is an allowable expense.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Contract (Definition)

Definition

Application: Contract is defined here for reference to contracting services (i.e. building, employment, alterations and renovations, etc.).

A contract is defined as a legally binding document guaranteeing reciprocal services by a vendor or person in exchange for a pre-determined payment.

Note: Some allowable training consultants, programs, and services require an agreement or contract execution.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Contractors, Consulting, and Reviews

Unallowable

Updated January 2023

(Excluding HCAHPS and Chargemaster Review)

Contractor and consulting fees, services, and payments (recurring or one-time) are unallowable. This includes contracting for a consultant to review current operations under an approved SHIP category. 

Some unallowable expenses include but are not limited to: 

Architecture Designs Outside Employee Contracts Retainer Fees
Program Evaluation/Consulting Vendor Consultation Alterations and Renovations

Note: It is understood that some companies providing "training" in an approved SHIP category may refer to themselves as a consultant or contractor. Please e-mail SHIP-TA@ruralcenter.org if clarification is needed.

Unallowable investment

Credentialing (Definition)

Definition

Credentialing is defined as proving a skill or level of operation to provide evidence of authority, status, rights, entitlement or privileges, or the like. Credentialing and associated costs, such as renewing physician credentials for patient admittance, is an unallowable expense.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Cybersecurity and/or HIT

Allowable
Accountable Care Organization (ACO)

Updated October 2024

SHIP supports HIT hardware/software and training, including risk assessments for cybersecurity.

Cybersecurity refers to any technology, measure, or practice for preventing cyberattacks or mitigating their impact.  A strong cybersecurity strategy protects all relevant IT infrastructure layers or domains against cyberthreats and cybercrime. Examples of allowable expenses include but are not limited to:

Critical Infrastructure

Security

Subscriptions for

Cybersecurity Software

Endpoint Security Application Security
Cloud Security Information Security
Mobile Security

Network Security

Allowable investment

Direct Patient Care (Definition)

Definition

Direct patient care occurs when a facility, its providers, or staff, provide services (directly or indirectly) to diagnose, stabilize, treat, repair, maintain, or improve the health of a patient regardless of patient status (inpatient, outpatient, swing bed, SNF, etc.) or location (med/surgical, emergency room, waiting room, ambulatory, etc.,), and is an unallowable expense.

Example: Telehealth implementation is an approved SHIP expenditure. Purchasing software and training that will enable staff to receive readings from a Bluetooth-enabled blood pressure cuff is allowable under telehealth implementation, but the blood pressure cuff itself is unallowable. Training on how to use the blood pressure cuff on the patient is unallowable. 

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Equipment (Definition)

Definition

Equipment is defined as a one-time purchase product used to perform or support a task. 

Patient Equipment: Fixed or mobile product to be used directly by a patient (for treatment or comfort) such as a whiteboard, Wi-Fi router, wheelchairs, or beds. This is an unallowable expense.

Medical Equipment: Fixed or mobile product to be used to diagnose, treat, and maintain a patient's health and wellbeing, whether in person or remotely via computer software. This is an unallowable expense.

Telehealth Equipment (Computer Hardware): Fixed or mobile products to support the integration and adoption of telehealth services within a facility. This is an allowable expense. See also: Hardware.

Training Equipment: Fixed or mobile products that will be used solely to support SHIP-approved training, such as a training crash cart. This is an allowable expense.

Office equipment: Fixed, mobile, or electronic equipment used solely to support day-to-day office operations. This is an unallowable expense.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Event Management

Unallowable

Updated January 2023

Event management software, hardware, or reporting that is completed to manage attendees, staff, or volunteers and event operations is not an allowable use of SHIP funds.

Unallowable investment

Fees and Fines

Unallowable

Updated January 2023

Fees and fines accrued in association with a service provided to the hospital, regardless of the SHIP-approval status, are not to be paid with SHIP funds.

Examples of unallowable fees include but are not limited to: 

Bank Service Fees Library Fees Penalty Fees
Insurance Fees Building Fines Violation Fines

Note that some costs are referred to as "fees" and may be allowable (like ACO Fees), fees in this context are subsidiary costs, the recurring cost for use of services, or lack thereof. 

Unallowable investment

Furniture (Defintion)

Definition

Furniture is defined as a one-time purchase product that is either fixed or moveable and required for the operation of an office, clinic, patient room, patient waiting room, or other facility space such as tables, chairs, stands, decorations, pictures, rugs, or curtains. Furniture expenses are unallowable.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

Hardware (Definition)

Definition

Hardware is defined as technology-based durable equipment as a one-time purchase to support a SHIP-approved category and is an allowable expense.

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

HCAHPS Surveys

Allowable
Value-Based Purchasing (VBP) Investment

Updated January 2023

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys completed for inpatient services are an allowable use of SHIP funds.

NOTE: Currently, HCAHPS is the only allowable SHIP survey. Costs associated with conducting surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable. This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns. 

Allowable investment

HCAHPS Surveys

Allowable
Value-Based Purchasing (VBP) Investment

Updated October 2024

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys completed for inpatient services are an allowable use of SHIP funds. Beginning in January 2025, collections of HCAHPS will be allowed via web-based platforms. 

NOTE: Currently, HCAHPS is the only allowable SHIP survey. Costs associated with conducting other types of CAHPS or non-HCAHPS surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable. This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.

Allowable investment

ICD-11

Allowable
Payment Bundling (PB)/Prospective Payment System (PPS)

Updated September 2023

Activities that support ICD-11 readiness and/or implementation are allowable. This includes, but is not limited to:

Computer software upgrades to support a future transition to ICD-11 Computer hardware that improves quality, efficiencies, and/or coding Social Drivers of Health and Population Health training to use Z-Codes 
Efficiency or QI training to minimize ICD-11 transition impacts on patients and staff Revenue Cycle Management training Updating ICD-10 software or hardware
ICD-11 system and/or coding training (individual hospitals or state-wide) ICD-11 Implementation  

Note: This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.

See also: Subscription, Recurring Payment, Training (Hardware/Software/Services)

Allowable investment

Indirect Costs

Allowable

Updated September 2023

Indirect Cost Calculation - Grantee may request the lesser of 15 percent of the award total or their current federally negotiated indirect cost rate agreement. Indirect costs are deducted from the total award amount, not in addition to the total award amount. Grantees are not required to take indirect costs.

Allowable investment

Infrastructure (Defintion)

Definition

Infrastructure is defined as physical support, addition, enhancement, or upgrade to ensure the operational continuance of a facility or program and is an unallowable expense. Infrastructure is often unseen and generally requires contractor and building services. An example of an infrastructure expenditure may be installing fiber optic cable for high-speed internet access, which is an unallowable expense. 

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

Definition

iPads and Tablets (including all mobile devices)

Unallowable

Updated January 2023

In general, costs associated with purchasing iPads, tablets, and mobile devices are unallowable. For purchases related to telehealth, please contact SHIP-TA@ruralcenter.org and copy your PO.

Some specific unallowable examples include but are not limited to: 

iPads Kindle Surface
iPhones Wearable Tech Tracking Devices
Survey Tools Tablet Chargers  

See also: Patient use supplies and equipment, office supplies.

Unallowable investment

Leadership Training

Unallowable

Updated January 2023

Leadership training refers to general training on leadership best practices, leadership skill building, management, etc. Expenses related to leadership training (contracts, trainers, material, speakers) are unallowable expenses. Any training that includes certification, accreditation, or license is unallowable. 

Examples of unallowable costs include, but are not limited to:

NRHA Certification Critical Access Hospital Certification CEO Certification
Fundraising Training Academic or Professional Mentorships Accreditations
Licensing Privileging Leadership Fundamentals

The National Rural Health Resource Center has a collection of Leadership Videos that are available at no cost to hospitals. Compiled through various programs The Center supports, these videos can be found under the "Show more" button.

Unallowable investment

Medical Equipment and Supplies (Including EMS)

Unallowable

Updated January 2023

All medical equipment used for the treatment or diagnosis of a patient's illness or injury is unallowable. Medical equipment that serves as day-to-day operational equipment is unallowable.

Examples of unallowable costs include but are not limited to:

Patient Lifts Patient Beds/Bed Lifts Blood Pressure Cuffs/Equipment
Oxygen Monitors Hand Washing Sinks Respirators
Purifiers Crash Carts Percussion Beds
Medical Books/Manuals Medical Pamphlets Stethoscopes
Refrigerators Medications Medication Dispensers
Sanitizers (UV Lights) Label Printing Thermometers

Note: Telehealth implementation is an allowable expense, however, purchases of Bluetooth or internet enabled medical devices is unallowable. 

Unallowable investment

Medical Training

Unallowable

Updated January 2023

Medical training is unallowable. Training for direct patient care, treatment, or response is unallowable.

Examples of unallowable costs include but are not limited to:

CPR Wound Care  Medical Credentialing
CNA Vein Location Training Medical Supplies Training
Medical Treatment Training Medical Tool Training Accident Intervention
Emergency Intervention Pharmaceutical Training Language Interpretation Training

Note: For SHIP spending purposes, there are significant differences between medical training to treat and training to identify and prevent. Training on how to respond to a patient who has fallen is unallowable, but training on how to recognize fall risks or identify hazards is allowable. 

Unallowable investment

Medicare Beneficiary Quality Improvement Project (MBQIP)

PO Pre-Approval
Value-Based Purchasing (VBP) Investment

Updated September 2023

Allowable MBQIP activities include vendor fees for HCAHPS surveys.

Note: This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your SHIP Project Officer with questions or concerns.

See also: HCAHPS Surveys, Surveys and Assessments

Requires project officer pre-approval.