<SEC-DOCUMENT>0000731012-19-000036.txt : 20190304
<SEC-HEADER>0000731012-19-000036.hdr.sgml : 20190304
<ACCEPTANCE-DATETIME>20190304123810
ACCESSION NUMBER:		0000731012-19-000036
CONFORMED SUBMISSION TYPE:	NT 10-K
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20181231
FILED AS OF DATE:		20190304
DATE AS OF CHANGE:		20190304
EFFECTIVENESS DATE:		20190304

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HEALTHCARE SERVICES GROUP INC
		CENTRAL INDEX KEY:			0000731012
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-NURSING & PERSONAL CARE FACILITIES [8050]
		IRS NUMBER:				232018365
		STATE OF INCORPORATION:			PA
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		NT 10-K
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-12015
		FILM NUMBER:		19652779

	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>NT 10-K
<SEQUENCE>1
<FILENAME>nt10-kx2018.htm
<DESCRIPTION>NT 10-K
<TEXT>
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<title>Document</title></head><body><div id="i_0_21"></div><div style="height:45pt;width:100%;"><div><font><br></font></div></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">UNITED STATES</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">SECURITIES AND EXCHANGE COMMISSION</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">Washington, D.</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">C. 20549</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">FORM 12b-25</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">NOTIFICATION OF LATE FILING</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:8pt;font-style:italic;line-height:120%;">(Check One)</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9746;  Form 10-K</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  Form 20-F</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  Form 11-K</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  </font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">Form 10-Q</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  Form 10-D</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  Form N-SAR</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#9744;  Form N-CSR</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">For Period Ended&#58; December 31, 2018</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#9744;  Transition Report on Form 10-K</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#9744;  Transition Report on Form 20-F</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#9744;  Transition Report on Form 11-K</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#9744;  Transition Report on Form 10-Q</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#9744;  Transition Report on Form N-SAR</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">For the Transition Period Ended&#58;</font></div><div><font><br></font></div><div><font><br></font></div><div><table style="margin-left:auto;margin-right:auto;border-collapse:collapse;text-align:left;text-indent:0pt;display:inline-table;width:99.990000%;"><tr><td style="width:1.0%;"></td><td style="width:48.000000%;"></td><td style="width:1.0%;"></td><td style="width:1.0%;"></td><td style="width:48.000000%;"></td><td style="width:1.0%;"></td></tr><tr><td colspan="6" style="padding-top:2px;padding-bottom:2px;height:14pt;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:top;border-top:1pt solid #000;border-bottom:1pt solid #000;border-left:1pt solid #000;padding-left:1pt;border-right:1pt solid #000;padding-right:1pt;"><font style="font-size:10pt;font-weight:700;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">Nothing in this form shall be construed to imply that the Commission has verified any information contained herein.</font></td><td colspan="3" style="display:none;"></td></tr></table></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">If the notification relates to a portion of the filing checked above, identify the Item(s) to which the notification</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">relates&#58;</font></div><div><font><br></font></div><div id="i_0_31"></div><div style="text-align:center;"></div><div style="position:relative;width:100%;height:45pt;width:100%;"><div style="position:absolute;bottom:0;width:100%;"><div><font><br></font></div></div></div><hr style="page-break-after:always"><div style="height:45pt;width:100%;"><div><font><br></font></div></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">PART I </font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">- REGISTRANT INFORMATION</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:20pt;font-weight:700;line-height:120%;">HEALTHCARE SERVICES GROUP, INC.</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">(</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">Full Name of Registrant</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">)</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">N&#47;A</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">(Form</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">er Name </font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">If Applicable)</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">3220 Tillman Drive,</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;"> Suite 300</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">(Address of Principal Executive Office (Street and Numb</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">er))</font></div><div style="text-align:center;"><font><br></font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">Be</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">n</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">s</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">alem</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">, PA 19020</font></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:9pt;font-weight:700;line-height:120%;">(City, State and Zip Code)</font></div><div style="text-align:center;"><font><br></font></div><div id="i_0_38"></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">PART II -</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;"> RULES 12b-25(b) AND (c)</font></div><div><font><br></font></div><div><table style="margin-left:auto;margin-right:auto;border-collapse:collapse;text-align:left;text-indent:0pt;display:inline-table;width:91.812865%;"><tr><td style="width:0.1%;"></td><td style="width:1.343949%;"></td><td style="width:0.1%;"></td><td style="width:0.1%;"></td><td style="width:0.436943%;"></td><td style="width:0.1%;"></td><td style="width:0.1%;"></td><td style="width:1.662420%;"></td><td style="width:0.1%;"></td><td style="width:1.0%;"></td><td style="width:90.356688%;"></td><td style="width:1.0%;"></td></tr><tr><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:middle;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Arial;color:#000000;background-color:rgb(255,255,255, 0.0);"></font></td><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;border-left:1pt solid #000;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">(a)</font></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">The reason described in reasonable detail in Part III of this form could not be eliminated without unreasonable effort or expense&#59;</font></td></tr><tr><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:middle;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Arial;color:#000000;background-color:rgb(255,255,255, 0.0);">&#9746;&#160;</font></td><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;border-left:1pt solid #000;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">(b)&#160;</font></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">The subject annual report, semi-annual report, transition report on Form 10-K, Form 20-F, Form 11-K, FORM N-CEN or Form N-CSR, or portion thereof, will be filed on or before the fifteenth calendar day following the prescribed due date&#59; or the subject quarterly report or transition report on Form 10-Q or subject distribution report on Form 10-D, or portion thereof, will be filed on or before the fifth calendar day following the prescribed due date&#59; and&#160;</font></td></tr><tr><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:middle;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Arial;color:#000000;background-color:rgb(255,255,255, 0.0);"></font></td><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;border-left:1pt solid #000;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">(c)&#160;</font></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">The accountant's statement or other exhibit required by Rule 12b-25(c) has been attached if applicable.&#160;</font></td></tr></table></div><div><font><br></font></div><div id="i_0_52"></div><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:12pt;font-weight:700;line-height:120%;">PART III - NARRATIVE</font></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">State below in reasonable detail why Forms 10-K, 20-F, 11-K, 10-Q, 10-D, N-SAR, N-CSR, or the transition report</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">or portion thereof, could not be filed within the prescribed time period.</font></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">Healthcare Services Group, Inc. (the &#8220;Company&#8221;) has determined it is unable to file its Annual Report on Form 10-</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">K for the year ended December 31, 2018 (the &#8220;Form 10-K&#8221;) within the prescribed time period, without</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">unreasonable effort or expense, due to the circumstances described below.</font></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">The Company received a letter in November 2017 from the Securities and Exchange Commission (the &#8220;SEC&#8221;)</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">regarding an inquiry that the SEC is conducting into earnings per share (&#8220;EPS&#8221;) calculation practices and</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">requesting that the Company voluntarily provide certain information and documents relating to its EPS rounding</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">and reporting practices. 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</font></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:120%;">If so, attach an explanation of the anticipated change, both narratively and quantitatively, and, if appropriate, state the reasons why a reasonable estimate of the results cannot be made.</font></div><div><font><br></font></div><div id="i_0_64"></div><div style="text-align:center;"><font><br></font></div><div style="position:relative;width:100%;height:45pt;width:100%;"><div style="position:absolute;bottom:0;width:100%;"><div><font><br></font></div></div></div><hr style="page-break-after:always"><div style="height:45pt;width:100%;"><div><font><br></font></div></div><div><table style="margin-left:auto;margin-right:auto;border-collapse:collapse;text-align:left;text-indent:0pt;display:inline-table;width:99.990000%;"><tr><td style="width:1.0%;"></td><td style="width:98.000000%;"></td><td style="width:1.0%;"></td></tr><tr><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:700;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">HEALTHCARE SERVICES GROUP, INC.&#160;</font></td></tr><tr><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:top;padding-left:1pt;padding-right:1pt;"><font style="font-size:8pt;font-weight:700;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">(Name of Registrant as Specified in Charter)&#160;</font></td></tr></table></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">has</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;"> caused this</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;"> notification</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;"> to be signed on its behalf by the undersigned hereunto duly authorized.</font></div><div><font><br></font></div><div><font><br></font></div><div style="text-align:center;margin-bottom:6pt;"><table style="margin-left:auto;margin-right:auto;border-collapse:collapse;text-align:left;text-indent:0pt;display:inline-table;width:98.976608%;"><tr><td style="width:1.0%;"></td><td style="width:29.019202%;"></td><td style="width:1.0%;"></td><td style="width:1.0%;"></td><td style="width:16.463811%;"></td><td style="width:1.0%;"></td><td style="width:1.0%;"></td><td style="width:48.516987%;"></td><td style="width:1.0%;"></td></tr><tr><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:700;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">HEALTHCARE SERVICES GROUP, INC.</font></td></tr><tr><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">Date&#58; March 4, 2019</font></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:right;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">By&#58;</font></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"><font style="font-size:10pt;font-weight:400;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">&#47;s&#47;   John C. Shea</font></td></tr><tr><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;padding-left:1pt;padding-right:1pt;"></td><td colspan="3" style="padding-top:2px;padding-bottom:2px;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:bottom;border-top:1pt solid #000000;padding-left:1pt;padding-right:1pt;"><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:100%;">Name&#58;   John C. Shea</font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:400;line-height:100%;">Title&#58;     Chief Financial Officer</font></div></td></tr></table></div><div><font><br></font></div><div><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">INSTRUCTION&#58; The form may be signed by an executive officer of the registrant or by any other duly authorized</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">representative. The name and title of the person signing the form shall be typed or printed beneath the signature.</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">If the statement is signed on behalf of the registrant by an authorized representative (other than an executive</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">&#160;</font><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;line-height:120%;">officer), evidence of the representative&#8217;s authority to sign on behalf of the registrant shall be filed with the form.</font></div><div><font><br></font></div><div><font><br></font></div><div><table style="margin-left:auto;margin-right:auto;border-collapse:collapse;text-align:left;text-indent:0pt;display:inline-table;width:99.990000%;"><tr><td style="width:1.0%;"></td><td style="width:31.333333%;"></td><td style="width:1.0%;"></td><td style="width:1.0%;"></td><td style="width:31.333333%;"></td><td style="width:1.0%;"></td><td style="width:1.0%;"></td><td style="width:31.333333%;"></td><td style="width:1.0%;"></td></tr><tr><td colspan="9" style="padding-top:2px;padding-bottom:2px;height:14pt;background-color:rgb(255,255,255, 0.0);text-align:center;vertical-align:bottom;border-top:1pt solid #000;border-left:1pt solid #000;padding-left:1pt;border-right:1pt solid #000;padding-right:1pt;"><font style="font-size:10pt;font-weight:700;font-family:Times New Roman;color:#000000;background-color:rgb(255,255,255, 0.0);">ATTENTION</font></td><td colspan="3" style="display:none;"></td><td colspan="3" style="display:none;"></td></tr><tr><td colspan="9" style="padding-top:2px;padding-bottom:2px;height:14pt;background-color:rgb(255,255,255, 0.0);text-align:left;vertical-align:top;border-bottom:1pt solid #000;border-left:1pt solid #000;padding-left:1pt;border-right:1pt solid #000;padding-right:1pt;"><div style="text-align:center;"><font style="background-color:rgb(255,255,255, 0.0);color:#000000;font-family:Times New Roman;font-size:10pt;font-weight:700;line-height:100%;">Intentional misstatements or omissions of fact constitute Federal Criminal Violations (See 18 U.S.C. 1001).</font></div></td><td colspan="3" style="display:none;"></td><td colspan="3" style="display:none;"></td></tr></table></div><div><font><br></font></div><div style="position:relative;width:100%;height:45pt;width:100%;"><div style="position:absolute;bottom:0;width:100%;"><div><font><br></font></div></div></div></body></html>
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