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.

Wellness Streaming Services
Allowable
Accountable Care Organization (ACO)

Updated May 2022

Software and hardware SHIP infrastructure for wellness streaming services as a population health project is an allowable use of SHIP funds.

Staff Salaries and Payroll
Unallowable

Updated May 2022

Hospital staff salary, benefits, incentives, and bonuses, of any kind, are unallowable.  

See also: COVID

Transferring Unused SHIP Funds to Another Participating Hospital
Unallowable

Updated May 2022

Unused SHIP funds cannot be transferred to another participating hospital.

Indirect Costs
Allowable

Updated May 2022

Indirect costs are deducted from the total award amount per state.

Indirect Cost Calculation - Grantee may request the lesser of 15 percent of the award total or their current federally negotiated indirect cost rate agreement. Indirect costs are deducted from the total award amount, not in addition to the total award amount. Grantees are not required to take indirect costs.

Training Travel and Lodging Expenses (Vendor)
Allowable
Accountable Care Organization (ACO)

Updated May 2022, See definitions: "Training," "Contract," and "Consulting/Reviews"  

Travel and lodging costs for vendors, contractors, or a subject matter expert (SME) to travel to and from SHIP-approved training are allowable. The hospital or network should request an invoice with all related training costs (including time, travel, and lodging) bundled as one single deliverable.

NOTE: SHIP Guidance doesn't approve travel for hospitals and state offices.

See also: Training

Fees and Fines
Unallowable

Updated May 2022, See Definitions: "Fees" and "Costs." 

Fees and fines accrued in association with a service provided to the hospital, regardless of the SHIP-approval status, are not to be paid with SHIP funds. Note that some costs are referred to as "fees" and may be allowable (like ACO Fees), fees in this context are subsidiary costs, the recurring cost for use of services, or lack thereof. 

Examples of unallowable fees include but are not limited to: 

Bank services fees, Library Fees, Penalty Fees, or any fines accrued through the use of services to the hospital.

See also: ACO Fees, PCMH Status Application Fee

Recurring Payment (Definition)
Definition

A recurring payment is defined as a pre-determined payment given over a pre-set schedule to continue services or products previously received or continuously received. Recurring payments are unallowable. Payments that occur each SHIP fiscal year for a SHIP-approved category, such as yearly ICD training, are not considered recurring and should be recorded as individual purchases.

Note: The SHIP allowable investment definitions do not replace the Code of Federal Regulation definition for a term. The terms in the search tool help nuance your understanding of how expenses are determined. 

Surveys and Assessments (Excluding HCAHPS)
Unallowable

Updated May 2022, See definitions: "Survey," "Assessment," "Contract," "Consulting/Reviews"

Costs associated with conducting surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable. This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns. 

Some unallowable examples include, but are not limited to:

Community Health Needs Assessment (CHNA), Outpatient Surveys, EDCAHPS, Hospital Financial Assessments, mock audits (including RHCs).

See also: HCAHPS

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.