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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90 results found

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

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

Allowable investment

Membership (Definition)

Definition

Membership is defined as an arrangement between a business and the facility whereas the facility has access to associated benefits. Memberships and associated fees such as American Hospital Association 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

Membership(s) (including EMS)

Unallowable

Updated January 2023

The cost associated with memberships in associations, professional societies, or other organizations that are in addition to and not required of a SHIP-qualifying training course is unallowable.

Examples of unallowable costs include but are not limited to:

Telehealth Network Fees Hospital Association Memberships Chamber Associations
Business Associations Credentialing Associations Networking 
Social Media Expenses Civic Organizations Sponsorships

Note: Some SHIP-qualifying training courses may require membership for staff to utilize approved training resources. If you find a trainer, or training company, that requires a membership it is best to e-mail ship-ta@ruralcenter.org and copy your PO for clarification.

Unallowable investment

Messaging, Marketing, Community Outreach

Unallowable

Updated September 2023

Public messaging, marketing, and community outreach campaign costs are unallowable.

Examples of unallowable costs include but are not limited to: 

Signage Directional Signage Safety Signage
Message Boards One-Sheets Push Cards
Posters Information Cards Video Production
Social Media Expenses Marketing Expenses Community Outreach Expenses
Flyers/Brochures Signage  
Unallowable investment

Mobile Language Line Workstation for Interpretation Services

PO Pre-Approval
Accountable Care Organization (ACO)

Updated January 2023

Mobile language line workstations may be allowable SHIP investments if used by hospital staff to support operational efficiency and increase equitable patient satisfaction.

Note: These investments require Project Officer pre-approval. If a hospital is interested in this investment, the State SHIP coordinator should email their project officer with the justification of how these services will support operational efficiency and increase equitable patient satisfaction.

Requires project officer pre-approval.

Office Supplies

Unallowable

Updated January 2023

Costs associated with purchasing office supplies are unallowable.

Examples of unallowable costs include but are not limited to: 

Pens and Pencils iPads Electronic Tablets
Paper Binders Printers and Printer Ink/Toner
Whiteboards Office Furniture Purifiers
Humidifiers Computers (office use) Storage
Computer Accessories Refrigerators Stylus
Telephones (Land or Wireless) Two-way Radios Office Software
Unallowable investment

Patient Safety (Equipment)

Unallowable

Updated January 2023

Purchases that support the physical treatment of the patient are unallowable expenses. This includes physical equipment. An example may be the purchase of a bed that aids in preventing falls. Fall prevention is a "patient safety" activity, but SHIP funds can't be spent on beds that directly aid in treating a patient. Therefore, it would be an unallowable expense.

Examples of unallowable costs include but are not limited to:

Stretchers Mattresses Guard Rails
Walkers Wheelchairs Ramps
Lifts Hand Rails Canes
Purifiers Noise Machines IV Locators/Guides

Note: This card pertains to equipment only. Please see the card for Patient Safety (Training) for more information.

Unallowable investment

Patient Safety (Security)

Unallowable

Updated May 2022

Purchases for hospital facility security, facility security assessments, and crisis management, including, but not limited to:

Security Cameras/Monitors Incident Response Training Behavioral Risk Factor Surveillance System (BRFSS)
Security/Alarm Systems Security Guards Security/Safety Monitoring

Note: Value Based Programs/Purchasing (VBP) section C: "patient safety" is about the quality of care given to patients. Please click "See more" for additional information. See also: Patient Safety (Equipment), Emergency Preparedness, Patient Safety.

Unallowable investment

Patient Safety (Training)

Allowable
Value-Based Purchasing (VBP) Investment

Updated January 2023

Costs for patient safety training to address performance issues related to Value-Based Program initiatives are allowable.

Examples may be training on recommendations, protocols, or information regarding best practices for patient safety and the quality of health care delivery or training on preserving confidentiality. According to the Agency of Healthcare Research and Quality (AHRQ), "safety" reduces the risk of harm and injury. Additionally, "quality" suggests striving for excellence and value. 

Examples of allowable costs include but are not limited to: 

Quality Reporting Data Collection Related Training or Software HCAHPS Data Collection Process Related Training Efficiency or Quality Improvement Training in Support of VBP Related Initiatives
Provider-Based Clinic Quality Measures Training Active Shooter Training (Non-medical Response)  

Note: Patient healthcare safety, security, and equipment that aids in treating a patient may also increase patient safety. The three are not the same, and direct patient care and hospital security measures are unallowable even if those measures increase patient safety measurements.

Allowable investment

Patient Use Supplies and Equipment (Including EMS)

Unallowable

Updated May 2022

Costs associated with purchasing patient-use supplies, equipment, and furniture are unallowable expenses.

Examples of unallowable cost include but are not limited to:

iPads/Tablets Patient Room Furniture Whiteboards
Communication Boards Hardwired Internet Patient Use Wi-Fi
Wireless Routers Chargers Dividers
Patient Assistance Equipment Stools Chairs
Televisions Carts Trays
Unallowable investment

Patient-Centered Medical Home (PCMH) Status

Definition

The patient-centered medical home (PCMH) is a provider-based model for care coordination that can be implemented within a primary care practice. The PCMH, as defined by the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Primary Care Collaborative, is a model for providing patient care that is comprehensive, patient-centered, coordinated, accessible, and high quality.

Definition

Patient-Centered Medical Home (PCMH) Status Application Fee

Allowable
Value-Based Purchasing (VBP) Investment

Updated May 2022, See definition: "Recurring Payment."

The Patient-Centered Medical Home (PCMH) process requires an initial fee at enrollment. Then the rural health clinic implements changes by going through training that provides quality or efficiency improvement in support of Value-Based Purchasing initiatives. This is an allowable investment.

Note: The application renewal fee after the initial enrollment is unallowable.

Allowable investment

Physician Waiver to Prescribe and Dispense Buprenorphine

Unallowable

Updated January 2023

Costs or fees associated with a physician-waiver to prescribe and dispense Buprenorphine are an unallowable expense.

Providers may apply for a waiver with the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Become a Buprenorphine Waivered Practitioner since this has an opioid component. This process is free of charge; therefore, SHIP funds should be applied to other activities.

Unallowable investment

Project ECHO (Extension for Community Healthcare Outcomes)

Allowable
Accountable Care Organization (ACO)

Updated January 2023

Project ECHO educates health care professionals in underserved communities to treat chronic complex diseases in value-based care and payment models. This videoconferencing technology is used to create learning networks and may be a disease registry and population health training activity, and is an allowable SHIP investment.

Allowable investment

Recurring Payment (Definition)

Definition

Updated January 2023

A recurring payment is defined as a pre-determined payment given over a pre-set schedule to continue services or products previously received or continuously received. Recurring payments are unallowable. Payments that occur each SHIP fiscal year for a SHIP-approved category, such as yearly ICD training, are not considered recurring and should be recorded as individual purchases.

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

Remote/Telepharmacy Services

Allowable
Accountable Care Organization (ACO)

Updated January 2023

Training, hardware, and software that support the application and implementation of remote pharmacy (telepharmacy) services are allowable. 

Some examples of allowable expenses include but are not limited to: 

Telepharmacy Software Telepharmacy Apps in Support of After-Hours Pharmacy Services Telepharmacy Machines/Hardware
Telepharmacy Machines that can also dispense pre-packaged medication Printer and Printer Supplied Used Exclusively with Telepharmacy Operations Computer

NOTE: The cost of personnel, medications, medication delivery, refilling pre-packaged medication, assistants, or hardware for direct patient care are unallowable. 

Allowable investment