0000731012-24-000006.txt : 20240108 0000731012-24-000006.hdr.sgml : 20240108 20240108170359 ACCESSION NUMBER: 0000731012-24-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231231 FILED AS OF DATE: 20240108 DATE AS OF CHANGE: 20240108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kush Andrew CENTRAL INDEX KEY: 0001704092 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 24520946 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] ORGANIZATION NAME: 08 Industrial Applications and Services 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_1704751430.xml FORM 4 X0508 4 2023-12-31 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001704092 Kush Andrew 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 0 1 0 0 EVP & Chief Operating Officer 1 Common Stock 2024-01-03 4 M 0 2816 0 A 28572 D Common Stock 2024-01-04 4 M 0 1700 0 A 30272 D Common Stock 2024-01-04 4 M 0 2003 0 A 32275 D Common Stock 2024-01-04 4 M 0 3318 0 A 35593 D Common Stock 2024-01-04 4 F 0 3742 0 D 31851 D Phantom Stock 2023-12-31 4 A 0 2857 10.37 A Common Stock 2857 12237 D Restricted Stock Units 2024-01-03 4 A 0 31226 0 A Common Stock 31226 31226 D Stock Option (right to buy) 10.36 2024-01-03 4 A 0 31944 10.36 A 2034-01-03 Common Stock 31944 31944 D Restricted Stock Units 2024-01-03 4 M 0 2816 0 D Common Stock 2816 2816 D Restricted Stock Units 2024-01-04 4 M 0 1700 0 D Common Stock 1700 0 D Restricted Stock Units 2024-01-04 4 M 0 2003 0 D Common Stock 2003 4004 D Restricted Stock Units 2024-01-04 4 M 0 3318 0 D Common Stock 3318 9953 D Shares issued at the conversion rate of 1-for-1. Shares of Phantom Stock are payable in-kind following termination of the Reporting Person's employment with Issuer. Acquired pursuant to an Issuer contribution under the Healthcare Services Group, Inc. Deferred Compensation Plan. These Restricted Stock Units vest at the rate of 20% annually, commencing on the first anniversary of the January 3, 2024 grant date. These Options shall become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 3, 2024 grant date. These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 3, 2020 grant date. These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2019 grant date. These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2021 grant date. These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2022 grant date. /s/ Michael Harrity, by Power of Attorney 2024-01-08