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.

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

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

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.

Community Paramedicine Hardware/Software
Allowable
Accountable Care Organization (ACO)

If the hospital and/or hospital-owned ambulance unit has a formal Community Paramedic Program (CPP), hardware and software to support the CPP to reduce emergency medical services (EMS) and emergency department misuse and readmissions are allowable investments. However, the use of SHIP funding for general EMS equipment is not an allowable investment.

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

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.

Brochures, Pamphlets, One Sheets, Push Cards, Post Cards
Unallowable

Printed materials that are given directly to the patient and for patient use even when used to increase quality or perception of quality are not allowable.

Hardwired Internet Connections
Unallowable

Costs associated with the permanent installation of internet hardware are not an allowable use of SHIP funds.

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 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.

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.  

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.