<SEC-DOCUMENT>0000731012-13-000068.txt : 20130903
<SEC-HEADER>0000731012-13-000068.hdr.sgml : 20130902
<ACCEPTANCE-DATETIME>20130726121847
<PRIVATE-TO-PUBLIC>
ACCESSION NUMBER:		0000731012-13-000068
CONFORMED SUBMISSION TYPE:	CORRESP
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20130726

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HEALTHCARE SERVICES GROUP INC
		CENTRAL INDEX KEY:			0000731012
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340]
		IRS NUMBER:				232018365
		STATE OF INCORPORATION:			PA
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		CORRESP

	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
</SEC-HEADER>
<DOCUMENT>
<TYPE>CORRESP
<SEQUENCE>1
<FILENAME>filename1.htm
<TEXT>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
	<head>
		<!-- Document created using WebFilings 1 -->
		<!-- Copyright 2008-2013 WebFilings LLC. All Rights Reserved -->
		<title>HCSG - SEC Response 1</title>
	</head>
	<body style="font-family:Times New Roman;font-size:10pt;">
<a name="sc117ebe973d943cd9c2d6be2513fc351"></a><div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div></div><br><div style="line-height:120%;text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;font-style:italic;font-weight:bold;text-decoration:underline;">VIA EDGAR</font></div><div style="line-height:120%;text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">July 26, 2013</font></div><div style="line-height:120%;text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Securities and Exchange Commission</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Division of Corporate Finance</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">100 F Street, N.E.</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Washington, D.C. 20549</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Attn:&#160;&#160;&#160;&#160;Cicely L. LaMothe, Senior Assistant Chief Accountant </font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Re:&#160;&#160;&#160;&#160;Healthcare Services Group, Inc. (the &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Company</font><font style="font-family:inherit;font-size:10pt;">&#8221; or &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">we</font><font style="font-family:inherit;font-size:10pt;">&#8221;)</font></div><div style="line-height:120%;text-align:justify;text-indent:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Form 10-K for the Year Ended December 31, 2012</font></div><div style="line-height:120%;text-align:justify;text-indent:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Filed on February 21, 2013</font></div><div style="line-height:120%;text-align:justify;text-indent:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">File No. 000-12015</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Dear Ms. LaMothe:</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">This letter responds to your letter dated July 12, 2013, which sets forth the comments of the staff (the &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Staff</font><font style="font-family:inherit;font-size:10pt;">&#8221;) of the Securities and Exchange Commission (the &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Commission</font><font style="font-family:inherit;font-size:10pt;">&#8221;) regarding the Company's Annual Report on Form 10-K for the year ended December 31, 2012 (the &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">2012 Form 10-K</font><font style="font-family:inherit;font-size:10pt;">&#8221;) and Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2013 (the &#8220;</font><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Q1 2013 Form 10-Q</font><font style="font-family:inherit;font-size:10pt;">&#8221;). </font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">For your convenience, we have included each of the Staff's comments in italics before the corresponding response.  The Staff's comments and the Company's responses thereto are numbered to correspond with the paragraphs numbered in your July 12, 2013 letter.  Where indicated below, the Company intends to draft its disclosure in future filings with the Commission under the Securities Exchange Act of 1934, as amended, to reflect the positions explained in the comment responses below.</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Pursuant to your letter dated July 12, 2013, the Company acknowledges the following:</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:24px;"><font style="font-family:inherit;font-size:10pt;">&#8226;</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">the Company is responsible for the adequacy and accuracy of the disclosure in the filing;</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:24px;"><font style="font-family:inherit;font-size:10pt;">&#8226;</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Staff comments or changes to disclosure in response to Staff comments do not foreclose the Commission from taking any action with respect to the filing; and</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:24px;"><font style="font-family:inherit;font-size:10pt;">&#8226;</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">the Company may not assert Staff comments as a defense in any proceeding initiated by the Commission or any person under the federal securities laws of the United States.</font></div></td></tr></table><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><br><div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;">1</font></div></div><hr style="page-break-after:always"><a name="s5ac7d79ab26f4c2890b553b0e7107090"></a><div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div></div><br><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Form 10-K for the year ended December 31, 2012</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations, page 17</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Fiscal Year 2012 Compared to Fiscal Year 2011, page 20</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:0px;"><font style="font-family:inherit;font-size:10pt;">1.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;font-style:italic;">Please tell us how the decrease in bad debt provision and worker's compensation and general liability insurance as a percentage of consolidated revenue explains the increase in total costs of services as a percentage of co</font><font style="font-family:inherit;font-size:10pt;font-style:italic;">nsolidated revenue.</font></div></td></tr></table><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Response:</font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">In evaluating the Company's total costs of services provided, we identified two key indicators as a percentage of consolidated revenue, which are presented on a quarterly and annual basis. As depicted in the financial table on page 20 of the 2012 Form 10-K, the bad debt provision and worker's compensation and general liability insurance decreased as a percentage of consolidated revenue. Although these key indicators have an inverse relationship to the increase in total costs of services provided as a percentage of consolidated revenue, the Company believed omitting such information would be misleading to the reader of the financial statements included in the 2012 Form 10-K and provided detailed explanations regarding the year-over-year percentage changes.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">The Company believes that the discussion in the Reportable Segments section, specifically on page 21, provides an understanding of the primary increase in our costs of services provided. For reference, we are organized into two reportable segments - Housekeeping and Dietary, each of which contributed 68% and 32%, respectively, of our 2012 total revenues. On a reportable segment level, we have identified two key indicators as a percentage of segment revenue: (1) labor and other labor costs and (2) supplies. The Housekeeping and Dietary costs associated with the key indicators represent 97%, respectively, of both Housekeeping and Dietary costs of services provided for the years ended December 31, 2012 and 2011, respectively. Based on this method and analysis, the Company concluded that the disclosure was adequate for comparative purposes and provided detailed explanations regarding the significant changes.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Nevertheless, to address the Staff's comment, in future filings, the Company will provide additional disclosure regarding the period-over-period changes in its results of operations on, both, a consolidated level and by reportable segment and to the extent applicable, will clarify that the decrease in bad debt provision and worker's compensation and general liability insurance as a percentage of consolidated revenue did not explain the increase in total costs of services provided as a percentage of consolidated revenue.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><br><div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;">2</font></div></div><hr style="page-break-after:always"><a name="s5c7606af8aab4428856592db806cac1d"></a><div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div></div><br><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Financial Statements</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Consolidated Statements Comprehensive Income, page 38</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:0px;"><font style="font-family:inherit;font-size:10pt;">2.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;font-style:italic;">We note that you have included cash dividends per common share on the face of your Consolidated Statements of Operations versus in the notes to your financial statements. Tell us how your disclosure complies with the </font><font style="font-family:inherit;font-size:10pt;font-style:italic;">guidance in ASC Topic 260-10-45-5.</font></div></td></tr></table><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Response:</font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">In future filings, the Company will remove cash dividends per common share from the face of the Consolidated Statements of Operations and include the per share impact of cash dividends on our outstanding weighted average number of basic shares in the notes to the consolidated financial statements to comply with the guidance in ASC Topic 260-10-45-5.</font></div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><a name="sb5809e105dc146fea8896cfdbdc9edc1"></a><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Note 7. Share-Based Compensation, page 52</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Employee Stock Purchase Plan, page 53</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:0px;"><font style="font-family:inherit;font-size:10pt;">3.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;font-style:italic;">Please tell us how you have concluded your employee stock purchase plan is non-compensatory. Cite all relevant accounting literature within your response.</font></div></td></tr></table><div style="line-height:120%;text-align:justify;padding-left:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Response:</font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">The Company has offered an employee stock purchase plan (the &#8220;ESPP&#8221;) to its eligible employees since January 2000. The ESPP qualifies as a non-compensatory plan for employees for federal income tax purposes under Section 423 of the Internal Revenue Code of 1986, as amended, if five requirements are satisfied:</font></div><div style="line-height:120%;text-align:justify;padding-left:48px;text-indent:-43px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:96px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:72px;"><font style="font-family:inherit;font-size:10pt;">1.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Eligibility</font><font style="font-family:inherit;font-size:10pt;">&#32;- All employees must be eligible, except employees with less than two years of service, part-time employees with 20 hours or less per week, seasonal employees and highly compensated employees may be excluded. All eligible employees' rights under the ESPP must be the same, except that the amount of stock available for purchase may be proportional to compensation. Additionally, shareholders with 5% or more ownership cannot participate.</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:96px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:72px;"><font style="font-family:inherit;font-size:10pt;">2.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Shareholder Approval</font><font style="font-family:inherit;font-size:10pt;">&#32;- The plan must be approved by shareholders within 12 months before or after adoption by the Board of Directors.</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:96px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:72px;"><font style="font-family:inherit;font-size:10pt;">3.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Grants</font><font style="font-family:inherit;font-size:10pt;">&#32;- A participant must be an employee at the option's grant date, and the participant's right to purchase such stock under the plan must not be transferable during the employee's life, even to family members or by gift. The purchase price for ESPP stock must not be less than the lesser of (i) 85% of fair market value at date of grant or (ii) 85% of fair market value at date of exercise. The total value of stock that any individual employee may purchase in any calendar year with respect to any single offering period cannot exceed $25,000 based on the stock's value at the offering commencement date, without application of any plan discount. Additionally, the stock cannot be purchased more than 27 months after the offering commencement date.</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:96px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:72px;"><font style="font-family:inherit;font-size:10pt;">4.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Exercise/Purchase</font><font style="font-family:inherit;font-size:10pt;">&#32;- The participant must have been employed by the Company continuously up to a date no more than three months before the purchase date.</font></div></td></tr></table><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:96px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:72px;"><font style="font-family:inherit;font-size:10pt;">5.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Holding Period</font><font style="font-family:inherit;font-size:10pt;">&#32;- In order for the employee to receive favorable tax treatment, the shares purchased under an ESPP must not be disposed of earlier than the later to occur of: (i) the date that is two years after the offering commencement date; or (ii) one year after the purchase date.</font></div></td></tr></table><div style="line-height:120%;text-align:justify;padding-left:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><br><div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;">3</font></div></div><hr style="page-break-after:always"><div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div></div><br><div style="line-height:120%;text-align:justify;padding-left:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">If all of the requirements are satisfied, the employee's receipt of the option and purchase of shares will not be taxable, even though at the date of exercise the stock will be readily tradable and will have a value at least 15% in excess of what the employee paid for the stock. Based on the Company's description of the ESPP on page 53 of the 2012 Form 10-K, we believe that the current ESPP in place meets the criteria of a non-compensatory plan under Section 423 of the Internal Revenue Code of 1986, as amended.</font></div><div style="line-height:120%;text-align:justify;padding-left:48px;text-indent:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;&#160;&#160;&#160;</font></div><div style="line-height:120%;text-align:justify;padding-left:48px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">While the Company believes the ESPP meets the criteria of a non-compensatory plan under the tax code, in accordance with ASC Topic 718-50-25, the Company has concluded that for accounting purposes, it does not meet the criteria of a non-compensatory plan. Therefore, the Company has recognized compensation expense related to ESPP in the consolidated financial statements. As depicted in the financial tables on pages 52 and 54 of the 2012 Form 10-K, the amount expensed under our ESPP was $641,000, $282,000 and $317,000 for the years ended December 31, 2012, 2011 and 2010, respectively. Accordingly, the Company does not believe that additional disclosure is required.</font></div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><a name="s08d5503f7a3c4803a0c51228a22ca0cb"></a><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Form 10-Q for the quarterly period ended March 31, 2013</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations, page 20</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Accounts and Notes Receivable, page 27</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman; font-size:10pt;"><tr><td style="width:48px;"></td><td></td></tr><tr><td style="vertical-align:top"><div style="line-height:120%;font-size:10pt;padding-left:0px;"><font style="font-family:inherit;font-size:10pt;">4.</font></div></td><td style="vertical-align:top;"><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;font-style:italic;">We note historically you have converted unpaid accounts receivable to interest bearing promissory notes as a mechanism to pursue collection of unpaid balances. For the quarter, your long term notes receivable balances have increased. Please consider expanding your discussion in future filings to address any potential trends in the credit quality of your receivables and the specific factors driving transfers between accounts and notes during the period.</font></div></td></tr></table><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;text-decoration:underline;">Response:</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">The Company believes that the discussion in the MD&amp;A of the Q1 2013 Form 10-Q regarding our regular evaluation of impairment or loss of value and policy for reserving client receivables, specifically on pages 24 and 25, provides an understanding of the methodology used to determine when converting unpaid client accounts to interest bearing notes is necessary. Additionally, the Company advises the Staff that our long term notes receivable amounts represented less than 1% of total assets for both the period ending March 31, 2013 and December 31, 2012.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">In order to minimize the risk of credit exposure, we do not accept clients with poor credit quality. However, because our clients' revenues are generally highly reliant on Medicare, Medicaid and other third-party payors' reimbursement funding rates and mechanisms, the overall effect of recent legislation and trends in the long-term care industry can impact our collections and payment terms. These clients include those who have terminated service agreements, slow payers experiencing financial difficulties, clients in bankruptcy and clients with which we are in litigation for collection.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">The Company expects to be successful in collecting all net receivables, including interest bearing promissory notes that were transferred from our accounts receivable during the period. The allowance for doubtful accounts reduces the Company's gross accounts and notes receivable to the amount the Company expects to collect.</font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;padding-left:41px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Nevertheless, to address the Staff's comment, in future filings and to the extent applicable, the Company will expand its discussion as new details and circumstances become known regarding credit quality trends and the factors driving transfers between accounts and notes receivable.</font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><br><div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;">4</font></div></div><hr style="page-break-after:always"><a name="sa75ea1a5f55e44fd893ded6d520beb20"></a><div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div></div><br><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">If you have any questions about the foregoing, please feel free to contact me at (267) 525-8524 or Kenneth A. Schlesinger, Esq. of Olshan Frome Wolosky LLP, the Company's outside legal counsel, at (212) 451-2252.</font></div><div style="line-height:120%;text-align:justify;padding-left:42px;text-indent:-42px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:center;font-size:10pt;"><div style="padding-left:0px;text-indent:0px;line-height:normal;padding-top:10px;"><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman;font-size:10pt;margin-left:auto;margin-right:auto;width:100%;border-collapse:collapse;text-align:left;"><tr><td colspan="2"></td></tr><tr><td width="38%"></td><td width="62%"></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Sincerely,</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;height:13px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;height:13px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr><tr><td style="vertical-align:bottom;border-bottom:1px solid #000000;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">/s/ John C. Shea</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;height:13px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;height:13px;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">John C. Shea</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Chief Financial Officer</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td></tr></table></div></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Enclosures</font></div><div style="line-height:120%;text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><div style="line-height:120%;text-align:center;font-size:10pt;"><div style="padding-left:0px;text-indent:0px;line-height:normal;padding-top:10px;"><table cellpadding="0" cellspacing="0" style="font-family:Times New Roman;font-size:10pt;margin-left:auto;margin-right:auto;width:100%;border-collapse:collapse;text-align:left;"><tr><td colspan="2"></td></tr><tr><td width="4%"></td><td width="96%"></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">cc:</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:left;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Shannon Sobotka, Securities and Exchange Commission</font></div></td></tr><tr><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="overflow:hidden;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">&#160;</font></div></td><td style="vertical-align:bottom;padding-left:2px;padding-top:2px;padding-bottom:2px;padding-right:2px;"><div style="text-align:justify;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;">Kenneth A. Schlesinger, Olshan Frome Wolosky LLP</font></div></td></tr></table></div></div><div style="line-height:120%;font-size:10pt;"><font style="font-family:inherit;font-size:10pt;"><br></font></div><br><div><div style="line-height:120%;text-align:center;font-size:10pt;"><font style="font-family:inherit;">5</font></div></div>	</body>
</html>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
