Small Rural Hospital Improvement Grant Program

The Small Rural Hospital Improvement Grant Program (SHIP) is a federally funded program through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy.

The federal grant provides additional resources to small rural hospitals to:

  • VBP - Improving data collection activities in order to facilitate reporting to Hospital Compare.
  • ACOs - Improving quality outcomes. Focus on activities that support QI such as reduction of medical errors as well as education and training in data collection and reporting and benchmarking.
  • Payment Bundling - Building accountability across the continuum of care. Funding could be used to improve care transitions between ambulatory and acute, acute to upstream acute and acute to step-down facility. This could be done in the form of training, clinical care transition protocol development or data collection that documents these processes.
  • PPS - Maintaining accurate PPS billing and coding such as updating charge masters or providing training in billing and coding.

The Iowa program was established per Iowa Code 135M.4 and


  • "Small" is defined as 49 available beds or less, as reported on the hospital's most recently filed Medicare Cost report, line 12.
    • The average daily census or average staffed bed count can NOT be used to determine hospital eligibility.
    • Hospitals reporting a licensed bed count greater than 49 on Line 12 but that staff 49 beds or fewer, may self-certify eligibility by submitting a written statement including: 1) the number of staffed beds at the time of the most recent cost report submission, 2) the cost reporting period of the most recently filed cost report, and 3) the signature of the certifying official.
  • Regarding eligibility, the 49 beds or less refer to acute care beds only and does not include psyche unit beds.
  • "Rural" is defined as located outside a Metropolitan Statistical Area (MSA); or located in a rural census tract of a MSA as determined under the Goldsmith Modification or the Rural Urban Commuting Areas (RUCAs) and
  • "Hospital" is defined as non-federal, short-term, general acute care facility.

Web Resources

To learn more about the Iowa Small Rural Hospital Improvement Program contact:

Amanda Ramirez | SHIP Coordinator

Iowa Department of Public Health
321 E. 12th St., 4th fl. Lucas Bldg
Des Moines, IA 50319
Phone: (515) 314-6912 | Fax: ( 515) 242-6384
E-mail: Amanda.Ramirez@idph.iowa.gov