First Priority: HCAHPS (CAHs) and ICD-10 (all hospitals) - both of these must be fully implemented and HCAHPS must be publicly reported to Hospital Compare before your hospital can select any other investment options. Priority is not given to one over the other. Your hospital may choose one or both.
Second Priority: If your hospital is already participating fully in HCAHPS and ICD-10, you may select a different investment listed on the SHIP purchasing menu
Third Priority: If your hospital has already completed ALL investments listed on the SHIP purchasing menu, your hospital may identify an alternative piece of equipment and/or service ONLY IF: a) the purchase will optimally affect your hospital's transformation into an accountable care organization, increase value-based purchasing objectives and/or aid in the adoption of ICD-10; and b) your hospital receives pre-approval from both your state SHIP Coordinator and the appropriate FORHP project coordinator.
2020-2021 SHIP PROJECT REIMBURSEMENT REQUEST
Following the instructions/priorities above, please select the activity(ies) that were part of the SHIP project. Provide the amount of total expenditures for each category. The total requested budget amount shall not exceed $10,286.95.
Allowable Expenditures: SHIP funds must be spent in the prioritized manner as exhibited above.
Non-Allowable Expenditures:
TOTAL REIMBURSEMENT SHALL NOT EXCEED $10,286.95
I, {name}, certify that the information within this application is correct and accurate.