Staff Salaries and Payroll
Updated May 2022
Hospital staff salary, benefits, incentives, and bonuses, of any kind, are unallowable.
![Unallowable investment](/sites/default/files/styles/medium/public/2023-01/ship-invest-unallowable.png?itok=5LegUvWS)
Updated May 2022
Hospital staff salary, benefits, incentives, and bonuses, of any kind, are unallowable.
A subscription is defined as an arrangement to continually receive services for a preset price. Subscription services solely in support of SHIP-approved categories such as ICD software are allowable.
Please note that subscriptions to ongoing or on-demand training (at-will training) are unallowable expenses. Subscriptions that "happen to include" a SHIP-approved expenditure should be avoided. Subscriptions must be purchased and used for the SHIP-approved category.
Examples of allowable expenses include but are not limited to:
SHIP Quality Reporting | HCAHPS | Quality Improvement Training |
Telehealth Platforms (Excluding Provider Fees) | Disease Registries | Population Health Databases |
ACO Subscriptions or Fees | ICD-10/11 Software Subscriptions |
Note: A common example is ICD Software. Whereas a hospital purchased one program that could be downloaded to multiple computers (or server accessed), many ICD companies have now moved to cloud-based subscription services where the hospital pays a "per user" license. This specific example would be allowable under "Payment Bundling, A: ICD-10 Software."
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
Subscriptions for products that provide critical services are becoming more prevalent in rural hospitals.
Some subscriptions are allowable.
Examples of allowable expenses include but are not limited to:
SHIP Quality Reporting | HCAHPS | Quality Improvement Training |
Telehealth Platforms (Excluding Provider Fees) | Disease Registries | Population Health Databases |
ACO Subscriptions or Fees | ICD-10/11 Software Subscriptions |
Note: A common example is ICD Software. Whereas a hospital purchased one program that could be downloaded to multiple computers (or server accessed), many ICD companies have now moved to cloud-based subscription services where the hospital pays a "per user" license. This specific example would be allowable under "Payment Bundling, A: ICD-10 Software."
Updated January 2023
Supplies are defined as consumable and thus replenishable objects or materials used to perform a task.
Medical Supplies: Replenishable treatment-centric products such as band aids, gauze, medications, bedpans, sanitizer, etc., are unallowable.
Patient Supplies: Replenishable patient-use centric products such as pamphlets, fliers, blankets, pillows, etc., are unallowable.
Training Supplies: Single-purpose supplies used in direct support of a SHIP allowable training, such as training books, training videos, training manuals, training software, and training hardware are an allowable expense. See also: Equipment, Hardware, and Software. Training supplies supporting credentialing, testing, and certifications (such as CPR) are unallowable.
Office Supplies: Durable or replenishable products used by staff in the day-to-day operation of the facility such as staplers, pencils, ink, and paper 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
Costs associated with conducting surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable.
Some unallowable examples include but are not limited to:
Community Health Needs Assessment(s) (CHNA) | Outpatient Surveys | EDCAHPS |
Hospital Finance Assessments | Mock Audits (Including RHCs) |
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.
Updated January 2023
Software and web applications that facilitate swing bed services are allowable uses of SHIP Funds.
Updated January 2023
Training, hardware, and software supporting the application and implementation of telehealth services (telemedicine, remote healthcare, telepharmacy, etc.) are allowable expenses.
Examples of allowable expenses may include but are not limited to:
Computers | Telehealth Software | Carts (For Free Movement of Telehealth Hardware) |
Cameras | Microphones | Wires, Connections, and Cables |
*Computers, iPads, and Tablets used for other purposes are unallowable. Hospitals must use them for telehealth applications and implementation.
Costs associated with diagnosis, treating, and stabilizing a patient through telehealth options are unallowable expenses. Example: The hospital can purchase a camera, but is not allowed to pay the tele-physician's fees for treatment.
Note: Telecommunication training, hardware, and software are unallowable. This is defined as supplies or equipment that provide communication aid but not patient care/efficiency. An example would be a Zoom subscription for staff meetings.
See also: CAH Telehealth Guide
Training is defined as learning a specific skill or process from a professional business or subject matter expert to improve outcomes and outputs related to a SHIP-approved category and is an allowable expense.
Training for direct patient care 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.
Updated August 4, 2022
Training concerning an approved SHIP category/sub-category is allowable. This includes costs associated with hardware, software, trainer (SME), and supplies (such as training manuals).
Training should not include tests, testing, certification, accreditation, credentialing, or any associated costs. Some training will conclude with a knowledge test for "training completion." This is allowable so long as it is not for certification, accreditation, or credentialing.
Conference fees need to be pre-approved by a PO. Please send the request with a copy (or link) of the conference agenda to your PO and SHIP-TA.
Examples of allowable training expenses include but are not limited to:
Provider-Based Clinic Quality Measure Training | CPOE Implementation Training | Alternative Payment Model Training |
Quality Payment Program Training | Disease Registry Training | Population Health Training |
Social Determinants of Health Screening Training | Systems Performance Training in Support of ACO or Shared Savings Initiatives | Mobile Health and Telehealth Software Training |
Community Paramedicine Hardware and Software | Health Information Technology Training for VBP and ACO | ICD-10 Software and Training |
S-10 Cost Report Training | Price Transparency Training | 340B Drug Pricing program Training |
Billing and Coding Training | Strategic Planning Development and Implementation | Mid-Level Manager Training |
Value Based Care |
Supplies associated with training(s) are allowable. Such supplies may include, but are not limited to, staff-use training whiteboards, training manuals, training books, training modules, and other necessary-to-the-efficiency supplies.
Note: Training for direct-patient care is unallowable. Examples of unallowable training would be CPR training, wound care, medical treatments, and training on medical equipment. It is important to note that medical or direct-patient care training that benefits a SHIP category (such as patient safety) is still unallowable.
Updated May 2022
Unused SHIP funds cannot be transferred to another participating hospital.
Voice recognition system for dictation to support increased quality, efficiency, and/or coding is an allowable use of SHIP funds.