Q3014 does not compensate the hospital for expenses you mention - electric, rent staff - only for the costs or originating the telehealth service. Q3014 actually pays substantially less than the facility fees associated with providing an outpatient clinic visit, so if you bill this fee with the expectation of compensation for those other costs, you'll be taking a big reduction in your payments.
I think the guidance issued by CMS here is not completely clear, but I would be inclined to interpret this to mean that yes, you can bill Q3014 to compensate the hospital for the added expenses of using telehealth.
Normally, for an E&M service rendered by a physician in an outpatient hospital department, the hospital would bill G0463 and receive compensation for the facility expenses of the clinic visit under APC 05012. In the guidance you've cited above, it does say that they hospital may bill the Q3014, but what is not clear to me is if this is in addition to G0463 or in place of it. Q3014 is supposed to reimburse only the added expense of originating the telehealth service, not the other expenses incurred by the facility involved in the care of the patient, which are billed under the CPT/HCPCS codes appropriate to the services themselves. As mentioned above, since the patient is at home, the hospital is not actually originating the telehealth services or providing any actual services at the patient's home, so I would presume is being fully compensated for their services by billing G0463. It seems to me that if you only bill Q3014, then you will be underpaid, but if you bill both G0463 and Q3014, you will be overpaid. However, the wording of the guidance does say that the hospital may bill the originating fee in this situation and it seems to me that this would be in addition to billing for any other services provided.
I'm finding that some of the guidance surround COVID-19 and telehealth services that has been issued by CMS seems to have been made without a great deal of thought and/or depth of understanding of the billing and reimbursement implications and is creating more questions than answers. In your place, I would contact your local Medicare contractor to see if you can get additional guidance on this, though with the understanding that it likely will not be easy to get a final answer and you may be forced to use your best judgment and just make a decision as to how you interpret these guidelines.
I hope this helps some rather than making the situation even more confusing, but I totally understand why you're confused here - I think we all are these days.