Form Type: 4

SEC EDGAR Link
Accession Number:0000731012-19-000025
Date:2019-01-02
Issuer: HEALTHCARE SERVICES GROUP INC (HCSG)
Original Submission Date:

Reporting Person:

KUSH ANDREW
3220 TILLMAN DRIVE
SUITE 300 BENSALEM, PA 19020

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
COMMON STOCK 2019-01-03 M 70 a $0.00 2,234 direct
COMMON STOCK 2019-01-04 M 1,700 a $0.00 3,934 direct
COMMON STOCK 2019-01-04 M 1,200 a $0.00 5,134 direct
COMMON STOCK 2019-01-04 F 949 d $0.00 4,185 direct
COMMON STOCK 2019-01-04 M 200 a $0.00 4,385 direct
COMMON STOCK 2019-01-05 M 125 a $0.00 4,510 direct
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
PHANTOM STOCK 0.0 2019-01-02 deemed execution date A 523 (a) common stock 523 $0.00 2,642 direct
RESTRICTED STOCK 0.0 2019-01-03 deemed execution date M 70 (d) common stock 70 $0.00 0 direct
RESTRICTED STOCK UNITS 0.0 2019-01-04 deemed execution date M 1,700 (d) common stock 1,700 $0.00 5,100 direct
RESTRICTED STOCK UNITS 0.0 2019-01-04 deemed execution date M 1,200 (d) common stock 1,200 $0.00 4,800 direct
RESTRICTED STOCK 0.0 2019-01-04 deemed execution date M 200 (d) common stock 200 $0.00 400 direct
RESTRICTED STOCK UNITS 0.0 2019-01-04 deemed execution date A 8,500 (a) common stock 8,500 $0.00 8,500 direct
STOCK OPTION (RIGHT TO BUY) 40.49 2019-01-04 deemed execution date A 10,000 (a) 2029-01-04 common stock 10,000 $40.49 10,000 direct
RESTRICTED STOCK 0.0 2019-01-05 deemed execution date M 125 (d) common stock 125 $0.00 125 direct
Footnotes
IDfootnote
f1 shares issued at the conversion rate of 1-for-1.
f2 acquired pursuant to an issuer contribution under the healthcare services group, inc. deferred compensation plan.
f3 shares of phantom stock are payable in-kind following termination of the reporting person's employment with issuer.
f4 these restricted stock awards shall vest at the rate of 20% annually, commencing on the first anniversary of the january 3, 2014 grant date.
f5 this grant was made prior to the reporting person becoming a section 16(a) filer, and as of the date of filing, a portion of this grant has already vested.
f6 these restricted stock units shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the january 4, 2017 grant date.
f7 these restricted stock units shall vest at the rate of 20% annually, commencing on the first anniversary of the january 4, 2018 grant date.
f8 these restricted stock awards shall vest at the rate of 20% annually, commencing on the first anniversary of the january 4, 2016 grant date.
f9 these restricted stock units shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the january 4, 2019 grant date.
f10 these options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the january 4, 2019 grant date.
f11 these restricted stock awards shall vest at the rate of 20% annually, commencing on the first anniversary of the january 5, 2015 grant date.
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