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.

Community Health Needs Assessment (CHNA)
Unallowable

Costs or fees associated with completing a Community Health Needs Assessment (CHNA) do not qualify as a SHIP Allowable Investment.

CHNAs are a fundamental part of health care operations.

Behavioral Risk Factor Surveillance System (BRFSS)
Unallowable

Conducting a Behavioral Risk Factor Surveillance System (BRFSS) survey for population health analysis does not qualify as an allowable investment as it isn’t training, equipment, or software in the ACO category, which covers population health. A population health analysis would however be allowable a Program activity.

Financial Hospital Assessments
Unallowable

SHIP funds cannot be used for financial assessments, therefore would not be allowable. See language under Use of Funds.

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.

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

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.

Security Camera Systems
Unallowable

Security camera and security systems used to provide ongoing and operational security and safety are not allowable uses 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, $1,560,000 (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.