0000731012-23-000073.txt : 20230531 0000731012-23-000073.hdr.sgml : 20230531 20230531195548 ACCESSION NUMBER: 0000731012-23-000073 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230530 FILED AS OF DATE: 20230531 DATE AS OF CHANGE: 20230531 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Visconto Jude CENTRAL INDEX KEY: 0001645229 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 23982696 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHCARE SERVICES GROUP INC CENTRAL INDEX KEY: 0000731012 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 232018365 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 BUSINESS PHONE: 2159381661 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 4 1 wk-form4_1685577333.xml FORM 4 X0407 4 2023-05-30 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001645229 Visconto Jude 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 1 0 0 0 0 Common Stock 2023-05-30 4 A 0 2835 14.11 A 6472 D Represents a grant of unvested deferred stock units ("DSU") which will become fully vested on the one year anniversary of the grant date. Such DSUs will be settled in shares of common stock on the first to occur of (i) five-year anniversary of the Date of Grant, (ii) the Participant's date of death, disability or separation from service; or (iii) the date of a Change of Control (the "Settlement Date"). A Participant may elect a further deferral beyond the Settlement Date pursuant to the rules of Code Section 409A. Amount represents 2,835 unvested DSUs and 3,637 vested DSUs. /s/ Michael Harrity, by Power of Attorney 2023-05-31