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.

Fetal Monitoring Machine or Novii Monitor

Fetal monitoring machines or Novii monitors do not qualify as a SHIP allowable investment.

Neither piece of equipment fits under the ACO activity Mobile Health for Telehealth or Telemedicine as both are considered telecommunications, not telehealth or telemedicine. Although both pieces of equipment would increase patient safety under Value-Based Purchasing, patient safety activities are related to patient safety training.

Patient Lift Equipment

The purchase of patient lift equipment does not qualify as a SHIP allowable investment.

Handwashing Sinks

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

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.

Patient iPad/Tablet

iPads, tablets, and other technology/hardware investments are not allowable for patient purposes.

Hospital Staff iPad/Tablet
PO Pre-Approval

iPads, tablets, and other technology/hardware investments may be allowable if they will be used by staff to support efficiencies.


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

Medical Ventilation Hoods

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. 

Efficiency or Quality Improvement Training in Support of ACO or Shared Savings Related Initiatives
Accountable Care Organization (ACO)

Quality improvement training such as the IHI Plan-Do-Study-Act (PDSA), Root Cause Analysis (RCA), TeamSTEPPS, Lean Process planning, Community Care Coordination and Chronic Care Management, CMS Abstraction & Reporting Tool, and other efficiency and quality improvement trainings are allowable investments.

Systems Performance Training in Support of ACO or Shared Savings Related Initiatives
Accountable Care Organization (ACO)

Systems performance training, including adopting a framework approach to transition to value-based system planning, is an allowable investment.

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.

Hardwired Internet Connections

Costs associated with the permanent installation of internet hardware 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, $1,009,121 (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.