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.

Architecture Design or Drafting Consulting Fees
Unallowable

Architecture design and/or drafting consulting costs or fees do not qualify as a SHIP Allowable Investment. Consulting fees of any kind are not allowable unless they are part of education and training.

Bank Service Fees
Unallowable

Costs or fees related to bank services that create efficiency, but are not presented as training, do not qualify as a SHIP Allowable Investment.

If training is provided to staff to increase efficiency or quality improvement in support of ACO or shared savings related initiatives, for example, revenue cycle management, this type of fee would qualify as a SHIP Allowable Investment.

ACO Fees
Allowable
Accountable Care Organization (ACO)

ACO fees are an allowable investment under the ACO category, as long as the hospital identifies how they will define progress to align with the state office’s SHIP goals.

Patient-Centered Medical Home (PCMH) Status Application Fee
Allowable
Value-Based Purchasing (VBP) Investment

The Patient-Centered Medical Home (PCMH) process requires a fee at enrollment and then the rural health clinic implements changes by going through training that provides quality or efficiency improvement training in support of Value-Based Purchasing initiatives. This is an allowable investment. However, the application renewal fee each year would not be considered allowable.

Medical Credentialing Costs
Unallowable

Medical credentialing costs and fees do not qualify as a SHIP Allowable Investment as they are ongoing operational costs.

Library Fees and Services
PO Pre-Approval
Value-Based Purchasing (VBP) Investment

Library fees and services that are used strictly for training access or material and not ongoing operational access can be an allowable use of SHIP funds but requires PO approval.

Handwashing Sinks
Unallowable

Hand sinks and hand wash stations, equipment, or installation of sinks do not qualify as a SHIP allowable investment.

These items are part of a hospital’s operational costs and are not clearly linked with the purpose and intent of the SHIP Program.

EMS Crew Equipment
Unallowable

Supplies and equipment used by emergency medical services (EMS) staff or EMS volunteers such as a stethoscope, watch, blood pressure cuff, and pulse oximeter do not qualify as SHIP allowable investment.

If the hospital and/or hospital-owned ambulance unit has a formal community paramedics program (CPP), hardware/software can be purchased to support the CPP to reduce EMS and emergency department misuse and readmissions. However, the use of SHIP funding for general EMS equipment is not allowable.

Stethoscopes
Unallowable

Stethoscopes that are manual, Bluetooth enabled, or telehealth purposed are not an allowable use of SHIP funds. 

Medical Ventilation Hoods
Unallowable

Medical ventilation hoods that provide for the dissipation of fumes, gases, smoke, or other harmful materials from a designated area are not an allowable use of SHIP funds. 

Automation
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Addition of automated doors, sinks, toilets, soap dispensers, etc. for the purpose of COVID-19 mitigation.

COVID-19 Laboratory Supplies
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Laboratory supplies and equipment for COVID-19 testing. 

Portable Equipment (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Portable equipment (such as a portable x-ray machine) that is used to prevent patients from being moved throughout a facility and to mitigate the spread of COVID-19.

Sanitation and Cleaning (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Sanitation and cleaning equipment (including disinfectant robots) to be used to mitigate the spread of COVID-19. Also includes ultraviolet sanitation devices.

Telemetry
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Upgrading or expanding for telemetry equipment as part of a larger COVID-19 mitigation strategy.

GlideScope
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with purchasing, maintaining, or operating a GlideScope™ or other similar equipment which allows for video laryngoscope (considered direct patient care).

Communication Equipment (for COVID-19)
PO Pre-Approval
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with the purchase, maintenance, or usage of communication equipment including 2-way radios, electronic messaging boards for COVID-19 testing and mitigation, and video streaming equipment. 

Community Health Needs Assessment (CHNA)
Unallowable

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

Updated: May 20222

Financial Hospital Assessments
Unallowable

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

Provider-Based Clinic Quality Measures Education/Training
Allowable
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
Allowable
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.

Remote Pharmacy Machines
Allowable
Accountable Care Organization (ACO)

Types of Remote pharmacy machines are an allowable SHIP hardware purchase for pharmacy services.

NOTE: Pharmacist services or medications are not allowable. 

Software Apps for Afterhours Pharmacy Services
Allowable
Accountable Care Organization (ACO)

After hours pharmacy services software apps that help support remote pharmacy services are an allowable use of SHIP funds. 

Note: Pharmacist services or medications are not allowable

Refrigerator or Refrigeration
Unallowable

Refrigerators used to keep and store medicines or medical supplies are not an allowable use of SHIP funds.

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, $1,560,000 (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.