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.

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.

Disease Registry Training and/or Software/Hardware
Allowable
Accountable Care Organization (ACO)

Last Updated 12/10/2021

Educational training hardware and software to support the development and implementation of a disease registry for care coordination is allowable.

Many programs that were previously single purchase software are now cloud-based computer programs and the fee allows sharing with other providers. Language supporting this can be found at the Agency for Healthcare Research and Quality.

Please see ACO section C for additional resources.

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.

Books/Manuals/Guides
Unallowable

Books, manuals, and/or guides are an allowable use of SHIP funds IF they are supported by training. Books and manuals alone are NOT an allowable use of SHIP funds.

Pricing Guidebooks and Manuals
Unallowable

Books or manuals that are used for continuous reference of standard pricing guidelines are not an allowable use of SHIP Funds.

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.

Mobile Language Line Workstation for Interpretation Services
PO Pre-Approval
Accountable Care Organization (ACO)

Mobile language line workstations, iPads, and tablets can potentially 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 justification of how these services will support operational efficiency and increase equitable patient satisfaction.

Staff-Provider Communication Whiteboards
Allowable
Value-Based Purchasing (VBP) Investment

Whiteboards used in conjunction with training for quality improvement are an allowable use of SHIP funds.

NOTE: Apart from training, whiteboards are not an allowable cost.  

Example of an allowable use of funds: If hospitals are doing a training on efficient and effective rounding, and part of that training requires the use of a whiteboard for implementing the rounding process and improving the quality and efficiency of providers and staff. 

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

Costs for testing, including procuring, providing, or processing COVID-19 tests (including at-home testing kits).

COVID-19 Simultaneous Multi-Disease Test
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Costs for testing using a simultaneous multi-disease test that must include COVID-19

COVID-19 Mitigation Activities
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Costs association with the mitigation of COVID-19 and other related respiratory disease.

COVID-19 Community Testing and Mitigation
Allowable
SHIP ARP COVID-19 Testing & Mitigation

The cost associated with COVID-19 testing education at hospitals and community locations including home health, hospice, and long-term care.

COVID-19 EMS Support
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Supporting EMS as it relates to COVID-19 testing and mitigation efforts, and as part of a system improvement process

Isolation Areas
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Alterations and renovations that do not qualify as construction to create isolation areas for potential COVID-19 patients

Surface Renovations
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Alterations and renovations that do not qualify as construction to update surfaces to more sanitary materials to mitigate COVID-19

Safe and Efficient Laboratories
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Alterations and renovations that do not qualify as construction to update laboratories or other key spaces for safer and more efficient COVID-19 testing.

Automation
Allowable
SHIP ARP COVID-19 Testing & Mitigation

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

Negative Pressure Spaces
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Creating negative pressure spaces within common spaces (such as waiting rooms and bathrooms), or in rooms to treat COVID-19 positive patients.

COVID-19 Temporary Structures
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Installing tents, sheds, or other temporary structures to use for COVID-19 testing or mitigation activities.

COVID-19 HVAC
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Purchasing and installing HVAC and associated expenses to improve COVID-19 mitigation efforts.

Ionized Filtration
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Purchasing and installing ionized filtration systems for HVAC units to improve COVID-19 mitigation efforts.

Personal Protective Equipment (PPE)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Devices for masks, fit testing masks, respirators, or other personal protective equipment used to mitigate the spread of COVID-19.

COVID-19 Education Materials
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Covid-19 related education materials (including vaccination education materials) for dissemination to the public. 

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.

Temperature Screening (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Temperature screening systems to be used to mitigate the spread of COVID-19. See COVID-19 Screen Staff as well.

Telemetry
Allowable
SHIP ARP COVID-19 Testing & Mitigation

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

Screening Staff (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Cost of paying screeners placed at facility entrance doors to protect patients and employees and mitigate the spread of COVID-19.

Courier Staff (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with staff couriering COVID-19 tests to a laboratory. 

Digital Meeting Technology (Software)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Digital meeting technology software purchases to conduct digital/virtual meetings to mitigate the spread of COVID-19 by maintaining physical distancing and reducing facility traffic. 

Electronic Health Records (EHR) (for COVID-19)
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Electronic health record (EHR) costs supportive of COVID-19 testing and mitigation. 

Direct Patient Care (for COVID-19)
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Costs related to treatment or direct patient care.

Vaccinations (for COVID-19)
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Vaccine purchases, dissemination (including boosters) of vaccinations, or supplies associated with COVID-19 vaccination (considered direct patient care). 

Construction (for COVID-19)
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Construction costs, including, but are not necessarily limited to permanent building additions, new permanent buildings, permanent building expansions, modular buildings (and installations), increasing the footprint of the facility, significant new ground disturbance, and projects with a total cost of $500,000 or more.  

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).

Ventilators
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with purchasing, maintaining, or operating ventilators or other similar equipment which allows for respiratory assistance (considered direct patient care).

Staff Salary & Benefits
Unallowable
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with increasing staff salaries, recruitment, retention, bonuses, incentives, or benefits such as hazard pay, employee childcare, housing allowances, travel allowances (not associated with COVID-19 courier services), meals, snacks, or other incentive benefits. See Screening Staff, Testing Staff, Courier Staff, or Travel Nurse for more information.

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

Costs associated with staff time spent on COVID-19 testing. 

Beds (For Covid-19)
PO Pre-Approval
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with purchasing, maintaining, upgrading beds/bedding, or other similar equipment for the benefit of COVID-19 mitigation and separation of patients that are not considered direct patient care (including percussion beds). 

Minor Alterations or Renovations (A/R) (for COVID-19)
PO Pre-Approval
SHIP ARP COVID-19 Testing & Mitigation

Minor alterations or renovations that exceed 50% of the hospital's total American Rescue Plan (ARP) award.

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. 

Proximity Badge Systems
PO Pre-Approval
SHIP ARP COVID-19 Testing & Mitigation

Costs associated with the purchase, maintenance, or operation of proximity badge systems to prevent hospital traffic and limit exposure to COVID-19.

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

Costs associated with the purchase, maintenance, or operation of any hospital vehicle.

Employee Burnout and Mental Health (for COVID-19)
PO Pre-Approval

Costs associated with designing and implementing employee burnout/mental health strategies.

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.