0000731012-24-000014.txt : 20240108 0000731012-24-000014.hdr.sgml : 20240108 20240108171620 ACCESSION NUMBER: 0000731012-24-000014 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: WAHL Theodore CENTRAL INDEX KEY: 0001454244 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 24521046 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_1704752169.xml FORM 4 X0508 4 2023-12-31 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001454244 WAHL Theodore 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 1 1 0 0 President & CEO 1 Common Stock 2023-12-31 4 A 0 2083 8.81 A 317892 D Common Stock 2024-01-04 4 M 0 8500 0 A 326392 D Common Stock 2024-01-03 4 M 0 15547 0 A 341939 D Common Stock 2024-01-04 4 M 0 10025 0 A 351964 D Common Stock 2024-01-04 4 M 0 16293 0 A 368257 D Common Stock 2024-01-04 4 F 0 16650 0 D 351607 D Phantom Stock 2023-12-31 4 A 0 4858 10.37 A Common Stock 4858 33855 D Restricted Stock Units 2024-01-04 4 M 0 8500 0 D Common Stock 8500 0 D Restricted Stock Units 2024-01-03 4 M 0 15547 0 D Common Stock 15547 15547 D Restricted Stock Units 2024-01-04 4 M 0 10025 0 D Common Stock 10025 20048 D Restricted Stock Units 2024-01-04 4 M 0 16293 0 D Common Stock 16293 48876 D Stock Option (right to buy) 10.36 2024-01-03 4 A 0 156735 10.36 A 2034-01-03 Common Stock 156735 156735 D Restricted Stock Units 2024-01-03 4 A 0 153213 0 A Common Stock 153213 153213 D Acquired by the Reporting Person through participation in the Healthcare Services Group, Inc. Employee Stock Purchase Plan. Total direct and indirect beneficial ownership by reporting person is 837,359. 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 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 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, 2021 grant date. These Restricted Stock Units vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2022 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, 2024 grant date. /s/ Michael Harrity, by Power of Attorney 2024-01-08