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
Unallowable

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
Unallowable

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

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.

Patient iPad/Tablet
Unallowable

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
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. 

ICD-10 Training
Allowable
Payment Bundling (PB)

Any training to support coding and reimbursement, documentation, or documentation improvements that result in increased coding compliance are 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.

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.

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.  

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.

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

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.

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. 

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.

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). 

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.

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.