Allowable Investments Search Tool

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.

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: 

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.

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.

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.

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: 

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.

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.

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.

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.

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.

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: 

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. 

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.

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.

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. 

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.

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.

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: 

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

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:

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.

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:

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

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. 

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.

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:

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.