(a) General.
  (1) All fees paid to the Department of State Health Services (department) are nonrefundable with the exception of inspection fees for inspections that were not conducted.
  (2) All fees shall be paid by check or money order made payable to the Department of State Health Services.
(b) License fees.
  (1) The fee for an initial license or a renewal license is $39 per bed based upon the design bed capacity of the hospital. The design bed capacity of a hospital is determined as follows.
    (A) The design bed capacity is the maximum number of patient beds that a hospital can accommodate in rooms that comply with the requirements for patient room suites in §133.163 of this title (relating to Spatial Requirements for New Construction) including beds, bassinets or cribs in critical care units (including neonatal nurseries), continuing care nursery beds, hospital-based skilled nursing units, medical nursing units, mental health and chemical dependency nursing units, pediatric and adolescent nursing units, obstetrical suites (including labor/delivery/recovery/postpartum (LDRP) beds), intermediate care beds, universal care beds, antepartum beds and postpartum beds. The design bed capacity does not include labor/delivery/recovery (LDR) beds, newborn nursery bassinets, or recovery beds.
    (B) The maximum design bed capacity includes beds that comply with the requirements in §133.163 of this title even if the beds are unoccupied or the space is used for other purposes such as offices or storage rooms, provided such rooms can readily be returned to patient use. All required support and service areas must be maintained in place. For example, the removal of a nurse station in an unused patient bedroom wing of 20 beds would effectively eliminate those 20 beds from the design capacity. Eliminating access to the medical gas outlets and nurse call would also remove bed(s) from the design capacity.
    (C) The number of licensed beds in a multiple-occupancy room shall be determined by the design even if the number of beds actually placed in the room is less than the design capacity.
  (2) A hospital shall submit a license fee for each design bed added as a result of adding a multiple-location hospital to its license. The fee is $39 per bed, regardless of the number of months remaining in the license period.
  (3) A hospital shall submit an additional license fee with the Final Construction Approval form for each new design bed resulting from an approved construction project. The fee is $39 per bed, regardless of the number of months remaining in the license period. The hospital shall also submit an additional plan review fee if the construction cost increases to the next higher fee schedule according to subsection (c)(4) of this section.
  (4) A hospital will not receive a refund of previously submitted fees should the hospital's design capacity decrease as a result of an approved construction project.
(c) Plan review fees. This subsection outlines the fees which must accompany the application for plan review and all proposed plans and specifications covering the construction of new buildings or alterations to existing buildings which must be submitted for review and approval by the department in accordance with §133.167 of this title (relating to Preparation, Submittal, Review and Approval of Plans, and Retention of Records).
  (1) Construction plans will not be reviewed or approved until the required fee and an application for plan review are received by the department.
  (2) Plan review fees are based upon the estimated construction project costs which are the total expenditures required for a proposed project from initiation to completion, including at least the following items.
    (A) Construction project costs shall include expenditures for physical assets such as:
      (i) site acquisition;
      (ii) soil tests and site preparation;
      (iii) construction and improvements required as a result of the project;
      (iv) building, structure, or office space acquisition;
      (v) renovation;
      (vi) fixed equipment; and
      (vii) energy provisions and alternatives.
    (B) Construction project costs shall include expenditures for professional services including:
      (i) planning consultants;
      (ii) architectural fees;
      (iii) fees for cost estimation;
      (iv) legal fees;
      (v) management fees; and
      (vi) feasibility study.
    (C) Construction project costs shall include expenditures or costs associated with financing, excluding long-term interest, but including:
      (i) financial advisor;
      (ii) fund-raising expenses;
      (iii) lender's or investment banker's fee; and
      (iv) interest on interim financing.
    (D) Construction project costs shall include expenditure allowances for contingencies including:
      (i) inflation;
      (ii) inaccurate estimates;
      (iii) unforeseen fluctuations in the money market; and
      (iv) other unforeseen expenditures.
  (3) Regarding purchases, donations, gifts, transfers, and other comparable arrangements whereby the acquisition is to be made for no consideration or at less than the fair market value, the project cost shall be determined by the fair market value of the item to be acquired as a result of the purchase, donation, gift, transfer, or other comparable arrangement.
  (4) The plan review fee schedule based on cost of construction is:
    (A) $100,000 or less--$300;
    (B) $100,001 to $600,000--$850;
    (C) $600,001 to $2,000,000--$2,000;
    (D) $2,000,001 to $5,000,000--$3,000;
    (E) $5,000,001 to $10,000,000--$4,000; and
    (F) $10,000,001 and over--$5,000.
  (5) If an estimated construction cost cannot be established, the estimated cost shall be based on $225 per square foot. No construction project shall be increased in size, scope, or cost unless the appropriate fees are submitted with the proposed changes.
(d) Construction inspection fees. A fee of $500 and an application for construction inspection for each inspection shall be submitted to the department at least three weeks prior to the anticipated inspection date. Construction inspections will not be conducted until all required fees are received by the department. If additional construction inspections of the proposed project are requested by the hospital, the appropriate additional fees shall be submitted prior to any inspections conducted by the staff of the department. When follow-up construction inspections are performed to verify plans of correction, the fee shall be submitted upon completion of the inspection.
(e) Cooperative agreement application fee. The application fee for a cooperative agreement is $10,000. The application fee shall be submitted with an application for a cooperative agreement and other documents in accordance with §133.62 of this title (relating to Cooperative Agreements).
(f) Subscription and convenience fee. The department is authorized to collect subscription and convenience fees, in amounts determined by the TexasOnline Authority, to recover costs associated with application and renewal application processing through TexasOnline, in accordance with Texas Government Code, §2054.111. At each renewal application, in addition to the license fee, there shall be a $20 TexasOnline subscription fee.

Source Note: The provisions of this §133.26 adopted to be effective June 21, 2007, 32 TexReg 3587