Allowable Investments Search Tool

In general, SHIP allowable investments include activities to assist small rural hospitals with their quality improvement efforts and with their adaptation to changing payment systems through investments in hardware, software and related trainings. This includes aiding with value and quality improvement.

Unallowable investments include, but are not limited to, travel costs, hospital services, hospital staff salaries, or general supplies. Hospitals should contact their State Office of Rural Health (SORH) with questions regarding the appropriateness or fit of a certain activity or hardware/software purchase. For additional clarifications, refer to Frequently Asked Questions (FAQs).

This tool classifies a number of example investment activities as Allowable, Unallowable, or PO Pre-Approval. This is not a comprehensive list. It is only intended to provide examples of allowable SHIP activities.

NRHA CAH CEO Certification
PO Pre-Approval

Costs or fees associated with the National Rural Health Association (NRHA) CAH CEO Certification may be allowable with PO Pre-Approval. 

SORH or hospital would need to define how each session relates to the SHIP funding categories. 

Nurse Certification Training

Nurse certification training is not an allowable use of SHIP funds.

Note: Any health care professional certification for license to practice is not allowable.

Medical Training and Certification

Training and/or certification for direct patient care including behavioral health training is not allowable. Examples: SANE-A (Sexual Assault Nurse Examiner), PMHCNS-BC (Adult Psychiatric-Mental Health Clinical Nurse Specialist), CTC (Computed Tomography Certification).

Rural Hospital Credentialing or Privileging

Costs associated with rural hospital-wide credentialing or providing privileges to physicians are not an allowable use of SHIP funds.

Community Health Needs Assessment (CHNA)

Costs or fees associated with completing a Community Health Needs Assessment (CHNA) do not qualify as a SHIP Allowable Investment.

CHNAs are a fundamental part of health care operations.

Behavioral Risk Factor Surveillance System (BRFSS)

Conducting a Behavioral Risk Factor Surveillance System (BRFSS) survey for population health analysis does not qualify as an allowable investment as it isn’t training, equipment, or software in the ACO category, which covers population health. A population health analysis would however be allowable a Program activity.

Financial Hospital Assessments

SHIP funds cannot be used for financial assessments, therefore would not be allowable. See language under Use of Funds.

Quality Reporting Data Collection-Related Training or Software
Value-Based Purchasing (VBP) Investment

CAHs should participate in Medicare Beneficiary Quality Improvement Project (MBQIP). Any activity to support process improvements that result in improved quality reporting or improved inpatient and outpatient measures for PPS acute care hospitals is allowable.

Provider-Based Clinic Quality Measures Education/Training
Value-Based Purchasing (VBP) Investment

Education/training for provider-based rural health clinic quality improvement reporting, including patient satisfaction survey scores, is allowable.

340B Drug Pricing Program Training
Payment Bundling (PB)

A 340B Drug Pricing Program training intended to increase efficiency or quality improvement in support of Prospective Bundling and Prospective Payment Systems initiatives is an allowable investment.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.