Hurlock David 4

4 · HEALTHCARE SERVICES GROUP INC · Filed Jan 4, 2018

Form 4

Period: 2018-01-02

Executive Vice President & COO

Transactions

Exercise/Conversion
Restricted Stock
2018-01-04−70→ 0 total
→ Common Stock (70 underlying)
Award
Restricted Stock Units
2018-01-04+6,000→ 6,000 total
→ Common Stock (6,000 underlying)
Exercise/Conversion
Restricted Stock Units
2018-01-04−300→ 1,200 total
→ Common Stock (300 underlying)
Award
Phantom Stock
2018-01-02$52.72/sh+331$17,450→ 6,179 total
→ Common Stock (331 underlying)
Award
Common Stock
2018-01-02$33.29/sh+195$6,492→ 4,079 total
Exercise/Conversion
Common Stock
2018-01-03+125→ 4,119 total
Exercise/Conversion
Common Stock
2018-01-04+300→ 4,489 total
Exercise/Conversion
Common Stock
2018-01-05+225→ 5,014 total
Exercise/Conversion
Restricted Stock
2018-01-03−125→ 125 total
→ Common Stock (125 underlying)
Exercise/Conversion
Restricted Stock
2018-01-05−225→ 450 total
→ Common Stock (225 underlying)
Tax Payment
Common Stock
2018-01-04−85→ 3,994 total
Exercise/Conversion
Common Stock
2018-01-04+70→ 4,189 total
Exercise/Conversion
Common Stock
2018-01-04+300→ 4,789 total
Award
Stock Option (right to buy)
2018-01-04+10,000→ 10,000 total
Exercise: $52.06Exp: 2028-01-04→ Common Stock (10,000 underlying)
Exercise/Conversion
Restricted Stock
2018-01-04−300→ 900 total
→ Common Stock (300 underlying)

Footnotes (11)

[F1]These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 4, 2018 grant date.
[F10]Acquired pursuant to an Issuer contribution under the Healthcare Services Group, Inc. Deferred Compensation Plan.
[F11]Shares of Phantom Stock are payable in-kind following termination of the Reporting Person's employment with Issuer.
[F2]Shares issued at the conversion rate of 1-for-1.
[F3]These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2018 grant date.
[F4]These Restricted Stock Units shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2017 grant date.
[F5]These Restricted Stock Awards shall vest at the rate of 20% annually, commencing on the first anniversary of the January 3, 2014 grant date.
[F6]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.
[F7]These Restricted Stock Awards shall vest at the rate of 20% annually, commencing on the first anniversary of the January 4, 2013 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 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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