(a) All fees paid to the Texas Health and Human Services Commission (HHSC) are nonrefundable with the exception of inspection fees for inspections that were not conducted.     
      (b) All fees shall be paid by check or money order made payable to HHSC.     
      (c) The license application fee for an initial license or a renewal license is $350.00.     
      (d) A limited services rural hospital (LSRH) shall submit a license fee regardless of the number of months remaining in the license period.     
      (e) An LSRH will not receive a refund of previously submitted fees should the LSRH's design capacity decrease as a result of an approved construction project.     
      (f) This subsection outlines the fees that must accompany the application for plan review and all proposed plans and specifications covering the alterations to existing buildings which the LSRH must submit for review and approval by HHSC in accordance with §511.167 of this chapter (relating to Preparation, Submittal, Review, and Approval of Plans, and Retention of Records).      
        (1) HHSC will not review or approve construction plans until HHSC receives the required fee and an application for plan review.       
        (2) HHSC bases plan review fees on the estimated construction project costs that 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, HHSC shall determine project cost by the fair market value of the item to be acquired as a result of the purchase, donation, gift, transfer, or other comparable arrangement.                  (A) The plan review fee schedule based on cost of construction is:                      (i) $100,000 or less--$300;                       (ii) $100,001 to $600,000--$850;                       (iii) $600,001 to $2,000,000--$2,000;                       (iv) $2,000,001 to $5,000,000--$3,000;                       (v) $5,000,001 to $10,000,000--$4,000; and                       (vi) $10,000,001 and over--$5,000.                     (B) 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 LSRH submits appropriate fees with the proposed changes.         
      (g) An LSRH shall submit a fee of $500 and a construction inspection application for each inspection to HHSC at least three weeks before the anticipated inspection date. HHSC will not conduct construction inspections until HHSC receives all required fees. If the LSRH requests additional construction inspections of the proposed project, the LSRH shall submit appropriate additional fees before HHSC conducts any inspections. When HHSC performs follow-up construction inspections to verify plans of correction, the LSRH shall submit the fee when HHSC completes the inspection.     
      (h) HHSC collects 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 (relating to Use of State Electronic Internet Portal Project) and §2054.252 (State Electronic Internet Portal Project).     
     Source Note:        The provisions of this §511.17 adopted to be effective October 5, 2023, 48 TexReg 5668