Quarterlytics / Healthcare / Medical - Care Facilities / Healthcare Services Group, Inc.

Healthcare Services Group, Inc.

hcsg · NASDAQ Healthcare
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Ticker hcsg
Exchange NASDAQ
Sector Healthcare
Industry Medical - Care Facilities
Employees 35300
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FY2018 Annual Report · Healthcare Services Group, Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

Form 10-K

þ

¨

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934

For the fiscal year ended December 31, 2018 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934

For the transition period from    to    
Commission file number: 0-12015

  HEALTHCARE SERVICES GROUP, INC.

Pennsylvania

23-2018365

(Exact
name
of
registrant
as
specified
in
its
charter)

(State
or
other
jurisdiction
of
incorporation
or
organization)

(I.R.S.
Employer
Identification
No.)

3220 Tillman Drive, Suite 300, Bensalem, PA

(Address
of
principal
executive
offices)

19020 

(Zip
Code)

Registrant’s telephone number, including area code:
(215) 639-4274

Securities registered pursuant to Section 12(b) of the 1934 Act:

Common Stock ($.01 par value)
Title
of
each
class

The NASDAQ Global Select Market
Name
of
each
exchange
on
which
registered

Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. YES   þ
    NO   ¨
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. YES   ¨
    NO   þ
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding
12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. YES   þ
    NO   ¨
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-
T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). YES   þ
    NO   ¨
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§ 229.405 of this chapter) is not contained herein, and will not be contained, to
the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.  
¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth
company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer 

þ

Non-accelerated filer  

o (Do not check if a smaller reporting company)

Accelerated filer 

Smaller reporting company  

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised
financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

o

o

o

o

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). YES   ¨
    NO   þ
The aggregate market value of the voting stock (Common Stock, $.01 par value) held by non-affiliates of the Registrant as of the close of business on June 30, 2018 was
approximately $2.02 billion based on the closing sale price of the Common Stock on the NASDAQ Global Select Market on that date. The determination of affiliate status is not
a determination for any other purpose. The Registrant does not have any non-voting common equity authorized or outstanding.

 
 
 
 
 
 
 
 
 
Indicate  the  number  of shares outstanding  of each of the  registrant’s  classes of Common  Stock  (Common  Stock,  $.01  par value)  as of  the  latest  practicable  date  (March  14,
2019). 74,036,000 

Portions of the definitive Proxy Statement for the Registrant’s Annual Meeting of Shareholders to be held on May 28, 2019 have been incorporated by reference into Parts II
and III of this Annual Report on Form 10-K.

DOCUMENTS INCORPORATED BY REFERENCE

Healthcare Services Group, Inc.
Annual Report on Form 10-K
For the Fiscal Year Ended December 31, 2018 

TABLE OF CONTENTS

Business
Risk Factors
Unresolved Staff Comments
Properties
Legal Proceedings
Mine Safety Disclosures

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Selected Financial Data
Management’s Discussion and Analysis of Financial Condition and Results of Operations
Quantitative and Qualitative Disclosures About Market Risk
Financial Statements and Supplementary Data
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Controls and Procedures
Other Information

Directors, Executive Officers and Corporate Governance
Executive Compensation
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Certain Relationships and Related Transactions, and Director Independence
Principal Accountant Fees and Services

Exhibits and Financial Statement Schedules
Form 10-K Summary

PART I
Item 1.
Item 1A.
Item 1B.
Item 2.
Item 3.
Item 4.

PART II
Item 5.
Item 6.
Item 7.
Item 7A.
Item 8.
Item 9.
Item 9A.
Item 9B.

PART III
Item 10.
Item 11.
Item 12.
Item 13.
Item 14.

PART IV
Item 15.
Item 16.
Exhibit Index
Signatures

1

3
8
13
13
14
14

15
17
17
30
31
63
63
63

64
64
64
64
64

65
65
67
68

Table of Contents

CAUTIONARY STATEMENT REGARDING FORWARD-LOOKING STATEMENTS

This Form 10-K may contain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the
Securities  Exchange  Act  of  1934,  as  amended,  which  are  not  historical  facts  but  rather  are  based  on  current  expectations,  estimates  and  projections  about  our
business and industry, and our beliefs and assumptions. Words such as “believes,” “anticipates,”  “plans,” “expects,” “will,” “goal,” and similar expressions are
intended to identify forward-looking statements. The inclusion of forward-looking statements should not be regarded as a representation by us that any of our plans
will be achieved. We undertake no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or
otherwise. Such forward-looking information is also subject to various risks and uncertainties. Such risks and uncertainties include, but are not limited to, risks
arising from our providing services exclusively to the healthcare industry, primarily providers of long-term care; having a significant portion of our consolidated
revenues contributed by one customer during the year ended December 31, 2018; credit and collection risks associated with the healthcare industry; our claims
experience  related  to  workers’  compensation  and  general  liability  insurance;  the  effects  of  changes  in,  or  interpretations  of  laws  and  regulations  governing  the
healthcare industry, our workforce and services provided, including state and local regulations pertaining to the taxability of our services and other labor-related
matters  such as minimum  wage increases;  the Company's expectations  with respect  to selling, general,  and administrative  expense; continued realization  of tax
benefits arising from our corporate reorganization and self-funded health insurance program; risks associated with the reorganization of our corporate structure;
realization of our expectations regarding the impact of the Tax Cuts and Jobs Act on our tax rates and financial results; and the risk factors described in Part I of
this report under “Government Regulation of Clients,” “Service Agreements and Collections,” and "Competition;" under Item IA. “Risk Factors.”

These factors, in addition to delays in payments from clients and/or clients in bankruptcy or clients with which we are in litigation to collect payment, have resulted
in, and could continue to result in, significant additional bad debts in the near future. Additionally, our operating results would be adversely affected if unexpected
increases  in  the  costs  of  labor  and  labor-related  costs,  materials,  supplies  and  equipment  used  in  performing  services  (including  the  impact  of  potential  tariffs)
could not be passed on to our clients.

In addition, we believe that to improve our financial performance we must continue to obtain service agreements with new clients, retain and provide new services
to existing clients, achieve modest price increases on current service agreements with existing clients and maintain internal cost reduction strategies at our various
operational  levels.  Furthermore,  we  believe  that  our ability  to sustain  the  internal  development  of managerial  personnel  is an  important  factor  impacting  future
operating results and the successful execution of our projected growth strategies.

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In this Annual Report on Form 10-K for the year ended December 31, 2018, Healthcare Services Group, Inc. (together with its wholly-owned subsidiaries listed in
Exhibit 21, which has been filed as part of this Report) is referred to using terms such as the “Company,” “we,” “us” or “our.”

PART I

Item I.  Business.

General

Healthcare  Service  Group,  Inc.  is  a  Pennsylvania  corporation,  incorporated  on  November  22,  1976.  We  provide  management,  administrative  and  operating
expertise and services to the housekeeping, laundry, linen, facility maintenance and dietary service departments of healthcare facilities, including nursing homes,
retirement  complexes,  rehabilitation  centers  and  hospitals  located  throughout  the  United  States.  We  believe  we  are  the  largest  provider  of  housekeeping  and
laundry management services to the long-term care industry in the nation, rendering such services to over 3,500 facilities throughout the continental United States
as of December 31, 2018.

Segment Information

The information called for herein is discussed below in Description of Services, and within Item 8   of this Annual Report on Form 10-K under Note 15—Segment
Information in the Notes to Consolidated Financial Statements for the years ended December 31, 2018, 2017 and 2016.

Description of Services

We are organized into two reportable segments: housekeeping, laundry, linen and other services (“Housekeeping”) and dietary department services (“Dietary”).
Our corporate headquarters provides centralized financial management and support, legal services, human resources management and other administrative services
to the Housekeeping and Dietary business segments.

We  provide  Housekeeping  services  to  essentially  all  of  our  client  facilities  and  provide  Dietary  services  to  over  1,500  facilities.  Although  we  do  not  directly
participate in any government reimbursement programs, our clients receive government reimbursements related to Medicare and Medicaid and are directly affected
by any legislation and regulations relating to those programs.

We provide services primarily pursuant to full service agreements with our clients. Under such agreements, we are responsible for the day-to-day management of
the employees located at our clients’ facilities, as well as the provision of certain supplies. We also provide services on the basis of management-only agreements
for a limited number of clients. Under a management-only agreement, we provide management and supervisory services while the client facility retains payroll
responsibility for the non-supervisory staff. Our agreements with clients typically provide for a renewable one year service term, cancelable by either party upon 30
to 90 days’ notice after an initial period of 60 to 120 days. 

We  typically  adopt  and  follow  our  clients’  employee  wage  structures,  including  policies  of  wage  rate  increases,  and  pass  through  to  the  client  any  labor  cost
increases associated with wage rate adjustments.

Our labor force is interchangeable with respect to the services within Housekeeping, while the Dietary labor force is specific to Dietary operations. In addition,
there  are  some  differences  in  the  expertise  of  the  professional  management  personnel  responsible  for  the  services  of  the  respective  segments.  We  believe  each
segment provides opportunities for growth.

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Housekeeping

Housekeeping  accounted  for  approximately  48.5%,  or  $973.8  million,  of  our  consolidated  revenues  in  2018.  The  services  provided  under  this  segment  include
managing our clients’  housekeeping  departments,  which are principally  responsible  for the cleaning,  disinfecting  and sanitizing  of resident  rooms and common
areas of the clients’ facilities, as well as the laundering and processing of the bed linens, uniforms, resident personal clothing and other assorted linen items utilized
at the clients’ facilities. Upon beginning service with a client facility, we typically hire and train the employees previously employed by such facility and assign an
on-site manager to supervise and train the front-line personnel and coordinate housekeeping services with other facility support functions in accordance with client
requests.  Such  management  personnel  also  oversee  the  execution  of  various  cost  and  quality-control  procedures  including  continuous  training  and  employee
evaluation, and on-site testing for infection control.

Housekeeping’s  operating  performance  is significantly  impacted  by our  management  of  labor  costs. Management  reviews  costs  as  a percentage  of revenues,  in
order to normalize and evaluate such costs in the context of the Company’s growth. Housekeeping labor costs represented approximately 78.8% of Housekeeping
revenues for 2018. Changes in employee compensation resulting from legislative or other governmental actions, market factors, adjustments to staffing levels, and
the composition of our labor force may adversely impact these costs. Similarly, an increase in the costs of supplies consumed in performing Housekeeping services
may impact Housekeeping’s operating performance. In 2018, the cost of Housekeeping supplies as a percentage of Housekeeping revenues was 7.8%. Generally,
the  cost  of  such  supplies  is  dictated  by  specific  product  market  conditions,  subject  to  price  fluctuations  influenced  by  factors  outside  of  our  control.  Where
possible, we negotiate fixed pricing from vendors for an extended period of time on certain supplies to mitigate such price fluctuations.

Dietary

Dietary services represented approximately 51.5%, or $1,035.0 million, of our consolidated revenues in 2018. Dietary services consist of managing our clients’
dietary departments, which are principally responsible for food purchasing, meal preparation and professional dietitian services, which include the development of
menus that meet the dietary needs of residents. On-site management is responsible for all daily dietary department activities, with regular support provided by a
District Manager specializing in dietary services. We also offer clinical consulting services to our dietary clients, which may be provided as a stand-alone service,
or bundled with other dietary department services. Upon beginning service with a client facility, we typically hire and train the employees previously employed by
such facility and assign an on-site manager to supervise and train the front-line personnel and coordinate dietitian services with other facility support functions in
accordance  with  client  requests.  Such  management  personnel  also  oversee  the  execution  of  various  cost  and  quality-control  procedures  including  continuous
training and employee evaluation.

Dietary  operating  performance  is  impacted  by  price  fluctuations  in  labor  and  supply  costs  resulting  from  similar  factors  discussed  above  for  Housekeeping.  In
2018, the costs of labor and food-related supplies represented approximately 57.2% and 34.4% of Dietary revenues, respectively.

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Significant Customers

For  the  years  ended  December  31,  2018  and  2017,  both  the  Housekeeping  and  Dietary  segments  earned  revenue  from  several  significant  customers,  including
Genesis  Healthcare,  Inc.  ("Genesis").  For  the  years  ended  December  31,  2018  and  2017,  Genesis  accounted  for  $386.7  million  or  19.3%  and  $327.5  million
or 17.5% of the Company's consolidated revenues, respectively.

Operational Management Structure

By applying our professional  management  techniques,  we offer  our clients  the ability  to manage certain  housekeeping, laundry, linen, facility  maintenance  and
dietary services and costs. We manage and provide our services through a network of management personnel, as illustrated below.

Vice President of Operations
↓
Director of Operations
↓
District Manager
↓
Facility Manager

Facilities  are  managed  by  an  on-site  Facility  Manager,  and  if  necessary,  additional  supervisory  personnel.  Such  facility-level  management  personnel  are
responsible for the management of staff, scheduling, procurement, customer service, quality control and overall day-to-day management of the Housekeeping or
Dietary function.

District Managers oversee the operations of the facilities within their districts. Their responsibilities include oversight of Facility Managers and management of
personnel, operational performance, quality control and customer satisfaction, while ensuring adherence to the Company’s systems and budgets.

Directors of Operations oversee District Managers and provide management support, training and personnel management, while ensuring operational performance
is consistent with the Company’s systems and budgets.

Vice Presidents of Operations are ultimately responsible for all aspects of the operations, compliance and financial performance of the Directors of Operations who
they oversee.

We believe that our organizational structure facilitates our ability to best serve and expand our service offerings to existing clients, while also securing new clients.

Market

The market for our services consists of a large number of facilities involved in various aspects of the healthcare industry, including long-term and post-acute care
facilities (e.g., skilled nursing facilities, residential care and assisted living facilities) and hospitals (e.g., acute care, critical access, psychiatric). Such facilities may
be  specialized  or  general,  privately  owned  or  public,  for-profit  or  not-for-profit,  and  may  serve  residents  on  a  long-term  or  short-term  basis.  We  market  our
services  to  facilities  after  consideration  of  a  variety  of  factors  including  facility  type,  size,  location,  and  service  opportunities  (Housekeeping  or  Dietary).  The
market  for  our  services,  particularly  in  long-term  and  post-acute  care,  is  expected  to  continue  to  grow  as  the  population  of  the  United  States  ages  and  as
government reimbursement policies require increased cost control or containment by the constituents that comprise our target market.

Marketing and Sales

Our services are primarily marketed by our Chief Revenue Officer, Vice Presidents of Sales and Directors of Sales. These marketing and sales efforts are supported
by all levels of our corporate and operational management team. We provide incentive compensation to our sales and operational personnel based on achieving
financial and non-financial goals and objectives, which are aligned with the key elements we believe are necessary for us to achieve overall improvement in our
financial results, along with continued business development.

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Our services are marketed primarily through referrals and in-person solicitation of target facilities. We also participate in industry trade shows, healthcare trade
associations and healthcare support service seminars that are offered in conjunction with state or local health authorities in many of the states in which we conduct
our business. Such programs are typically attended by facility owners, administrators and supervisory personnel, thus presenting marketing opportunities for us.
Indications of interest in our services arising from initial marketing efforts are followed up with a presentation regarding our services and an assessment of the
service  requirements  of  the  facility.  Thereafter,  a  formal  proposal,  including  operational  recommendations  and  proposed  costs,  is  submitted  to  the  prospective
client. Once the prospective client accepts the proposal and executes our service agreement, we are structured to timely and efficiently establish our operations and
systems at the client facilities.

Government Regulation of Clients

We do not directly participate in any government reimbursement programs and our contractual relationships with our clients determine their payment obligations to
us.  However,  our  clients  are  subject  to  government  regulation  and  laws  and  rulings  which  directly  affect  how  they  are  paid  for  certain  services  they  provide.
Therefore, because our clients’ revenues are generally highly reliant on Medicare and Medicaid reimbursement funding rates, the overall effect of laws and trends
in the long-term care industry have affected and could adversely affect our clients’ cash flows, resulting in their inability to make payments to us in accordance
with  agreed  upon  payment  terms  (see  “Liquidity  and  Capital  Resources”  included  in  our  “Management’s  Discussion  and  Analysis  of  Financial  Condition  and
Results of Operations”).

The prospects for legislative action, both on the federal and state level, regarding funding for nursing homes are uncertain. We are unable to predict or to estimate
the ultimate impact of any further changes in reimbursement programs affecting our clients’ future results of operations and/or their impact on our cash flows and
operations.

Environmental Regulation

Our operations are subject to various federal, state and/or local laws concerning emissions into the air, discharges into waterways and the generation, handling and
disposal of waste and hazardous substances. Our past expenditures relating to environmental compliance have not had a material effect on our cash flows or results
of  operations  and  are  included  in normal  operating  expenses.  These laws  and  regulations  are  constantly  evolving,  and  it is  impossible  to  predict  accurately  the
effect they may have upon the capital expenditures, earnings and our competitive position in the future. Based upon information currently available, we believe that
expenditures relating to environmental compliance will not have a material impact on the financial position of the Company.

Service Agreements and Collections

We have historically had a favorable client retention rate and expect to continue to maintain satisfactory relationships with our clients, despite many of our service
agreements being cancelable on short notice.

We have had varying collections experiences with respect to our accounts and notes receivable. We have sometimes extended the period of payment for certain
clients beyond contractual terms. Such clients include those who have terminated service agreements and slow payers experiencing financial difficulties. In order
to provide for such collection issues and the general risk associated with the granting of credit terms, we have recorded bad debt provisions (in an Allowance for
Doubtful  Accounts)  of  $51.4  million,  $6.3  million  and  $4.6  million  in  the  years  ended  December  31,  2018,  2017  and  2016,  respectively  (see  Schedule  II  -
Valuation and Qualifying Accounts and Reserves for year-end balances). As a percentage of total revenues, these provisions represented approximately 2.6% for
the  year  ended  December  31,  2018,  and  0.3%  for  the  years  ended  December  31,  2017  and  2016.  The  increase  to  our  bad  debt  provision  for  2018    related to
multiple corporate restructurings of privately-held, multi-facility operators that occurred during 2018 that resulted in increased expense compared to our historical
experience.  In making our credit evaluations, in addition to analyzing and anticipating, where possible, the specific cases described above, we consider the general
collection  risk  associated  with  trends  in  the  long-term  care  industry.  We  establish  credit  limits,  perform  ongoing  credit  evaluations  and  monitor  accounts  to
minimize the risk of loss. Despite our efforts to minimize credit risk exposure, clients could be adversely affected if future industry trends change in such a manner
as to negatively impact their cash flows. If our clients experience a negative impact on their cash flows, it could have a material adverse effect on our results of
operations and financial condition.

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Competition

We compete primarily with the in-house service departments of our potential clients. Most healthcare facilities perform their own support service functions without
relying  upon  outside  management  firms.  In  addition,  a  number  of  local  firms  compete  with  us  in  the  regional  markets  in  which  we  conduct  business.  Several
national service firms are larger and have greater financial and marketing resources than we do, although historically such firms have concentrated their marketing
efforts primarily on hospitals, rather than the long-term care facilities typically serviced by us.

Employees

At  December  31,  2018,  we  employed  over  55,000  people,  of  which  approximately  6,600  were  corporate  and  field  management  personnel.  The  Company's
employment of some of its employees is subject to collective bargaining agreements that are negotiated by individual client facilities and are assented by us, so as
to bind us as an “employer” under the agreements. In other cases, we are direct parties to the agreements. We may be adversely affected by relations between our
client facilities and their employee unions, or between us and such unions. We consider our relationship with our employees to be good.

Available Information

Healthcare  Services  Group,  Inc.  is  a  reporting  company  under  the  Securities  Exchange  Act  of  1934,  as  amended,  and  files  reports,  proxy  statements  and  other
information with the Securities and Exchange Commission (the “Commission” or “SEC”). The public may read and copy any of our filings at the Commissioner’s
Public Reference Room at 100 F Street, N.E., Washington, D.C. 20549. You may obtain information on the operation of the Public Reference Room by calling the
Commission at 1-800-SEC-0330. Additionally, because we make filings to the Commission electronically, you may access this information at the Commission’s
internet site: www.sec.gov
. This site contains reports, proxies and information statements and other information regarding issuers that file electronically with the
Commission.

Website Access

Our website address is www.hcsg.com
. Our filings with the Commission, as well as other pertinent financial and Company information, are available at no cost on
our website as soon as reasonably practicable after the filing of such reports with the Commission.

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Item 1A.     Risk Factors.

You should carefully consider the risk factors we have described below, as well as other related information contained within this annual report on Form 10-K as
these factors could materially and adversely affect our business, results of operations, financial condition and cash flows. We believe that the risks described below
are our most significant risk factors but there may be risks and uncertainties that are not currently known to us or that we currently deem to be immaterial.

We provide services to several clients which contribute significantly, on an individual as well as an aggregate basis, to our total revenues.

We have several clients who individually contributed over 3%, with Genesis contributing 19.3% and 17.5%, of our total consolidated revenues for the years ended
December  31,  2018  and  2017,  respectively.  Although  we  expect  to  continue  the  relationship  with  these  clients,  there  can  be  no  assurance  thereof.  The  loss,
individually or in aggregate, of such clients, or a significant reduction in the revenues we receive from such clients, could have a material adverse effect on the
results of operations of our two operating segments and the Company. In addition, if any of these clients change or alter current payment terms it could increase
our accounts receivable balance and have a material adverse effect on our cash flows.

Our clients are concentrated in the healthcare industry, which is subject to changes in government regulation. Many of our clients rely on reimbursement from
Medicare, Medicaid and other third-party payors. Rates from such payors may be altered or reduced, thus affecting our clients’ results of operations and cash
flows.

We provide our services primarily to providers of long-term and post-acute care. We cannot predict what efforts, and to what extent, legislation and proposals to
contain healthcare costs will ultimately impact our clients’ revenues through reimbursement rate modifications. Congress has enacted a number of laws during the
past decade that have significantly altered, and may continue to alter, overall government reimbursement for nursing home services. Because many of our clients’
revenues are highly reliant on Medicare, Medicaid and other third-party payors’ reimbursement funding rates and mechanisms, the overall effect of these laws and
trends in the long-term care industry have affected and could adversely affect our clients’ cash flows, resulting in their inability to make payments to us on agreed
upon payment terms. These factors, in addition to delays in payments from clients have resulted in, and could continue to result in, significant additional bad debts
in the future.

Changes to federal healthcare legislation may adversely affect our operating costs and results of operations.

Continued changes to the healthcare structure and regulations related to the health insurance industry in the United States could impact our operating costs. Any
requirements to provide additional benefits to our employees or the payment of penalties if such benefits are not provided, would increase our expenses. If we are
unable to pass-through these charges to our clients to cover these expenses, such increases could adversely impact our operating costs and our results of operations.

In addition, often new regulations result in additional reporting requirements for businesses. These and other requirements could result in increased costs, expanded
liability exposure, and other changes in the way we provide healthcare insurance and other benefits to our employees.

We have clients located in many states which have had and may continue to 

experience significant budget deficits and such deficits may result in reduction of


reimbursements to nursing homes.

Many states in which our clients are located have significant budget deficits as a result of lower than projected revenue collections and increased demand for the
funding  of  entitlements.  As  a  result  of  these  and  other  adverse  economic  factors,  state  Medicaid  programs  have  and  may  continue  to  revise  reimbursement
structures for nursing home services. Any disruption or delay in the distribution of Medicaid and related payments to our clients will adversely affect their cash
flows and impact their ability to pay us as agreed upon for the services provided.

The Company has substantial investment in the creditworthiness and financial condition of our customers.

The  largest  current  asset  on  our  balance  sheet  is  the  accounts  and  notes  receivable  balance  from  our  customers.  We  grant  credit  to  substantially  all  of  our
customers.  Deterioration  in  the  financial  condition  of  a  significant  component  of  our  customer  base  could  hinder  our  ability  to  collect  amounts  due  from  our
customers. Potential causes of such declines include national or local economic downturns, customers’ dependence on continued Medicare and Medicaid funding
and the impact of additional regulatory actions.

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We have sometimes been required to extend the period of payment for certain clients beyond contractual terms. Such clients include those who have terminated
service  agreements  and  slow  payers  experiencing  financial  difficulties.  In  order  to  provide  for  such  collection  issues  and  the  general  risk  associated  with  the
granting of credit terms, we have recorded bad debt provisions (in an Allowance for Doubtful Accounts) of $51.4 million for the year ended December 31, 2018 as
compared to $6.3 million and $4.6 million in the years ended December 31, 2017 and 2016, respectively. In making our credit evaluations, in addition to analyzing
and anticipating, where possible, the specific cases described above, we consider the general collection risk associated with trends in the long-term care industry.
We  establish  credit  limits,  perform  ongoing  credit  evaluations  and  monitor  accounts  to  minimize  the  risk  of  loss.  Despite  our  efforts  to  minimize  credit  risk
exposure, clients could be adversely affected if future industry trends change in such a manner as to negatively impact their cash flows. If our clients experience a
negative impact on their cash flows, it could have a material adverse effect on our results of operations, financial condition and cash flows.

We have a Paid Loss Retrospective Insurance Plan for general liability and 

workers’ compensation insurance.

We carry a high deductible general liability and workers’ compensation program and therefore retain a substantial portion of the risk associated with the possible
losses under such programs. Under our insurance plans for general liability and workers’ compensation, predetermined loss limits are arranged with our insurance
company to limit both our per occurrence cash outlay and annual insurance plan cost. We regularly evaluate our claims pay-out experience and other factors related
to the nature of specific claims in arriving at the basis for our accrued insurance claims estimate. Our evaluation is based primarily on current information derived
from reviewing our claims experience and industry trends. In the event that our known claims experience and/or industry trends result in an unfavorable change in
initial estimates of costs to settle such claims resulting from, among other factors, the severity levels of reported claims and medical cost inflation, it would have an
adverse  effect  on  our  consolidated  results  of  operations,  financial  condition  and  cash  flows.  Although  we  engage  third-party  experts  to  assist  us  in  estimating
appropriate reserves, the determination of the required reserves is dependent upon significant actuarial judgments. Changes in our insurance reserves as a result of
our periodic evaluation of the related liabilities may cause significant fluctuations in our operating results.

Federal, state and local tax rules can adversely impact our results of operations and financial position.

We are subject to federal, state and local taxes in the United States. Significant judgment is required in determining the provision for income taxes. We believe our
income tax estimates are reasonable. Although, if the Internal Revenue Service or other taxing authority disagrees on a tax position we’ve taken and upon final
adjudication we are required to change such position, we could incur additional tax liability, including interest and penalties. Such costs and expenses could have a
material  adverse  impact  on  our  results  of  operations,  financial  condition  and  cash  flows.  Additionally,  the  taxability  of  our  services  is  subject  to  various
interpretations  within  the  taxing  jurisdictions  in  which  we  operate.  Consequently,  in  the  ordinary  course  of  business,  a  jurisdiction  may  contest  our  reporting
positions with respect to the application of its tax code to our services. A conflicting position taken by a state or local taxation authority on the taxability of our
services could result in additional tax liabilities and could negatively impact our competitive position in that jurisdiction. If we fail to comply with applicable tax
laws and regulations, we could suffer civil or criminal penalties in addition to the delinquent tax assessment. In the taxing jurisdictions where our services have
been determined to be subject to tax, the jurisdiction may increase the tax rate assessed on such services. We seek to pass-through to our clients such tax increases.
In  the  event  we  are  not  able  to  pass-through  any  portion  of  the  tax  increase,  our  results  of  operations,  financial  condition  and  cash  flows  could  be  adversely
impacted.

Our business and financial results could be adversely affected by unfavorable 

results of material litigation or governmental inquiries.

We are currently involved in civil litigation and government inquiries which arise in the ordinary course of business. These matters relate to, among other things,
general  liability,  payroll  or  employee-related  matters.  Legal  actions  could  result  in  substantial  monetary  damages  and  expenses  and  may  adversely  affect  our
reputation and business status with our clients, whether or not we are ultimately determined to be liable. The outcome of litigation, particularly class action and
collective  action  lawsuits  and  regulatory  actions,  is  difficult  to  assess  or  quantify.  The  plaintiffs  in  these  types  of  actions  may  seek  recovery  of  very  large  or
indeterminate amounts, and estimates may remain unknown for substantial periods of time.

9

Table of Contents

We assess contingencies to determine the degree of probability and range of possible loss for potential accrual in our financial statements. We would accrue an
estimated  loss  contingency  in  our  financial  statements  if  it  were  probable  that  a  liability  had  been  incurred  and  the  amount  of  the  loss  could  be  reasonably
estimated. Due to the unpredictable nature of litigation, assessing contingencies is highly subjective and requires judgments about future events. The amount of
actual  losses  may  differ  from  our  current  assessment.  As  a  result  of  the  costs  and  expenses  of  defending  ourselves  against  lawsuits  or  claims,  and  risks  and
consequences of legal actions, regardless of merit, our results of operations and financial position could be adversely affected or cause variability in our results
compared to expectations.

A significant majority of our customer base are multi-facility management groups and independent facility operators who lease the buildings in which they
operate and may experience risks relating to their leases including termination, escalators, extensions and special charges.

The credit worthiness of our existing clients, and potential clients, is impacted by their ability to maintain positive relationships with their respective landlords.
Any loss or deterioration in the relationship between our clients and their respective landlords may adversely affect their financial condition and ability to make
payments on their service agreement with us on agreed upon terms. Any failure by our clients to make rent payments or comply with the provisions of their lease
terms could result in the termination of such lease agreements. In such cases, our clients may lose their ability to continue conducting operations and as a result
terminate their service agreements with us.

We primarily provide our services pursuant to agreements which have a one year 

term, cancelable by either party upon 30 to 90 days’ notice after an initial 60
to 120 day service agreement period.

We  do  not  enter  into  long-term  contractual  agreements  with  our  clients  for  the  rendering  of  our  services.  Our  agreements  with  clients  typically  provide  for  a
renewable  one  year  service  term,  cancelable  by either  party  upon  30 to  90 days’  notice  after  an initial  period  of  60 to  120 days.  Consequently,  our  clients  can
unilaterally decrease the amount of services we provide or terminate all services pursuant to the terms of our service agreements. Any loss of a significant number
of clients during the first year of providing services, for which we have incurred significant start-up costs or have invested in equipment installations, could in the
aggregate materially adversely affect our consolidated results of operations and financial position.

The Company’s business success depends on the management experience of our key personnel.

We manage and provide our services through a network of management personnel, from on-site facility managers to our executive officers. Therefore, we believe
that our ability to recruit and sustain the internal development of managerial personnel is an important factor impacting future operating results and our ability to
successfully  execute  projected  growth  strategies.  Our  professional  management  personnel  are  the  key  personnel  in  maintaining  current  and  selling  additional
services to existing clients and obtaining new clients.

Governmental  regulations  related  to  labor,  employment,  immigration  and  health  and  safety  could  adversely  impact  our  results  of  operations  and  financial
condition.

Our business is subject to various federal, state, and local laws and regulations in areas such as labor, employment, immigration, and health and safety. These laws
frequently evolve through case law, legislative changes and changes in regulatory interpretation, implementation and enforcement. Our policies and procedures and
compliance programs are subject to adjustments in response to these changing regulatory and enforcement environments, which could increase our cost of services
provided. Although we have contractual rights to pass cost increases we incur to our clients due to regulatory changes, our delay in, or inability to pass such costs
through to our clients, could have a material adverse effect on our financial condition, results of operations and cash flows.

In addition, if we fail to comply with applicable laws, we may be subject to lawsuits, investigations, criminal sanctions or civil remedies, including fines, penalties,
damages, reimbursement, or injunctions. Also, our clients’ facilities are subject to periodic inspection by federal, state, and local authorities for compliance with
state and local departments of health requirements. Expenses resulting from failed inspections of the departments that we service could result in our clients being
fined and seeking recovery from us, which could also adversely impact our financial condition, results of operations and cash flows.

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Table of Contents

We may be adversely affected by inflationary or market fluctuations, including impact of tariffs, in the cost of products consumed in providing our services or
our cost of labor. Additionally, we rely on certain vendors for housekeeping, laundry and dietary supplies.

The prices we pay for the principal items we consume in performing our services are dependent primarily on current market prices. We have consolidated certain
supply purchases with national vendors through agreements containing negotiated prospective pricing. In the event such vendors are not able to comply with their
obligations under the agreements and we are required to seek alternative suppliers, we may incur increased costs of supplies.

Dietary supplies, to a much greater extent than Housekeeping supplies, are impacted by commodity pricing factors, including the impact of tariffs, which in many
cases are unpredictable and outside of our control. We seek to pass on to clients such increased costs but sometimes we are unable to do so. Even when we are able
to pass on such costs to our clients, from time to time, sporadic unanticipated increases in the costs of certain supply items due to market or economic conditions
may result in a timing delay in passing on such increases to our clients. It is this type of spike in Dietary supplies costs that could most adversely affect Dietary’s
operating performance. The adverse effect would be realized if we delay in passing on such costs to our clients or in instances where we may not be able to pass
such increase on to our clients until the time of our next scheduled service  billing review. We seek to mitigate the impact of an unanticipated  increase in such
supplies’ costs through consolidation of vendors, which increases our ability to obtain more favorable pricing.

Our cost of labor may be influenced by factors in certain market areas or changes in the respective collective bargaining agreements to which we are a party. A
substantial number of our employees are hourly employees whose wage rates are affected by increases in the federal or state minimum wage rates, wage inflation
or  local  job  market  adjustments.  As  collective  bargaining  agreements  are  renegotiated,  we  may  need  to  increase  the  wages  paid  to  bargaining  unit  employees
covered by such collective bargaining agreements. Although we have contractual rights to pass such union and minimum wage increases through to our clients, our
delay in, or inability to pass such wage increases through to our clients could have a material adverse effect on our financial condition, results of operations and
cash flows.

Any perceived or real health risks related to the food industry could adversely affect our Dietary segment.

We are subject to risks affecting the food industry generally including food spoilage and food contamination. Our products are susceptible to contamination by
disease-producing organisms, or pathogens, such as listeria monocytogenes, salmonella, campylobacter, hepatitis A, trichinosis and generic E. coli. Because these
pathogens are generally found in the environment, there is a risk that these pathogens could be introduced to our products as a result of improper handling at the
manufacturing,  processing  or  food  service  level.  Our  suppliers’  manufacturing  facilities  and  products  are  subject  to  extensive  laws  and  regulations  relating  to
health, food preparation, sanitation and safety standards. Difficulties or failures by these companies in obtaining any required licenses or approvals or otherwise
complying with such laws and regulations could disrupt their operations which could adversely affect our operations. Furthermore, there can be no assurance that
compliance with governmental regulations by our suppliers will eliminate the risks related to food safety. To the extent there is an outbreak of food related illness
in any of our client facilities, it could materially harm our business, results of operations and financial condition.

Additionally, the Company may be subject to liability if the consumption of our food products causes injury, illness or death. Even if a product liability claim is
unsuccessful  or  is  not  fully  pursued,  the  negative  publicity  surrounding  any  assertion  that  our  products  caused  injury  or  illness  could  adversely  affect  our
reputation.

Changes  in  interest  rates  and  changes  in  financial  market  conditions  may  result  in  fluctuating  and  even  negative  returns  in  our  investments,  and  could
increase the cost of the borrowings under our borrowing agreements.

Although management believes we have a prudent investment policy, we are exposed to fluctuations in interest rates and in the market value of our investment
portfolio which could adversely impact our financial condition and results of operations. Our marketable securities consist of municipal bonds. We believe that our
investment  criteria,  which  include  diversification  among  issuers  of  bonds,  requirements  regarding  credit  ratings  and  monitoring  of  our  investments’  duration
periods, reduce our exposure related to the financial distress and budget shortfalls that many state and local governments currently face. Increases in market interest
rates could adversely affect our payment obligations with respect to our variable-rate borrowing agreements and adversely affect our liquidity and earnings.

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Table of Contents

Investor and market expectations regarding our financial performance are high and rely greatly on execution of our growth 

strategy and related increases in
financial performance.

Management believes the historical performance of our Common Stock reflect high market expectations for our future operating results. Our ability to attract new
clients through organic growth or acquisitions, and retain existing clients, has enabled us to execute our growth strategy and increase market share historically,
however  there  can  be  no  guarantee  that  we  will  be  able  to  do  so  in  the  future.  Our  business  strategy  focuses  on  growth  and  improving  profitability  through
obtaining service agreements with new clients, providing new services to existing clients, obtaining modest price increases on service agreements with clients and
maintaining internal cost reduction strategies at our various operational levels. With respect to providing new services to new or existing clients, our strategy is to
achieve  corresponding  profit  margins  in  each  of  our  segments.  If  we  are  unable  to  continue  either  historical  client  revenue  and  profitability  growth  rates  or
projected improvement, our operating performance may be adversely affected and the high expectations for our market performance may not be met. Any failure to
meet the market’s high expectations for our revenue and operating results may have an adverse effect on the market price of our Common Stock.

The  SEC’s  investigation  into  our  earnings  per  share  (“EPS”)  calculation  practices  could  result  in  potential  sanctions  or  penalties,  distraction  to  our
management and result in litigation from third parties, each of which could adversely affect or cause variability in our financial results.

Beginning in November 2017, the Company has been in dialogue with the SEC regarding EPS calculation, rounding and reporting practices and in March 2018 we
learned that the SEC had opened a formal investigation into these matters. In response to the SEC’s investigation, during the fourth quarter of 2018, the Company
authorized its outside counsel to conduct an internal investigation, under the direction of the Company’s Audit Committee regarding these matters. The internal
investigation was completed in March 2019, prior to the filing of this Annual Report on Form 10-K.

Notwithstanding the completion of the internal investigation, the SEC’s investigation is ongoing and there can be no assurance that the SEC or another regulatory
body will not make further regulatory inquiries or pursue further action that could result in significant costs and expenses including potential sanctions or penalties
as well as distraction  to management.  In addition, the Company may be subject to litigation  from third parties related to the matters under review by the SEC.
Accordingly, the ongoing SEC investigation and/or any related litigation could adversely affect or cause variability in our financial results.

Failure to maintain effective internal control over financial reporting could have a material adverse effect on our ability to report our financial results on a
timely and accurate basis.

Failure to maintain appropriate and effective internal controls over our financial reporting could result in misstatements in our financial statements and potentially
subject us to sanctions or investigations by the SEC or other regulatory authorities, and could cause us to delay the filing of required reports with the SEC and our
reporting of financial results. Any of these events could result in a decline in the market price of our Common Stock. Although we have taken steps to maintain our
internal control structure as required, we cannot guarantee that control deficiencies will not result in a misstatement in the future.

Any decrease in or suspension of our dividend could cause our stock price to decline.

We  expect  to  continue  to  pay  a  regular  quarterly  cash  dividend.  However,  our  dividend  policy  and  the  payment  of  future  cash  dividends  under  the  policy  are
subject to the final determination each quarter by our Board of Directors that (i) the dividend will be made in compliance with laws applicable to the declaration
and payment of cash dividends, including Section 1551(b) of the Pennsylvania Business Corporation Law, and (ii) the policy remains in our best interests, which
determination will be based on a number of factors, including the impact of changing laws and regulations, economic conditions, our results of operations and/or
financial condition, capital resources, financial covenants under our credit facility and other factors considered relevant by the Board of Directors. While we have
continually increased the amount of our dividends, given these considerations, there can be no assurance these increases will continue and our Board of Directors
may increase or decrease the amount of the dividend at any time and may also decide to suspend or discontinue the payment of cash dividends in the future. Any
decrease in the amount of the dividend, or suspension or discontinuance of payment of a dividend, could cause our stock price to decline.

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Table of Contents

Cyber-attacks and breaches could cause operational disruptions, fraud or theft of sensitive information.

Aspects  of  our  operations  are  reliant  upon  internet-based  activities,  such  as  ordering  supplies  and  back-office  functions  such  as  accounting  and  transaction
processing,  making  and  accepting  payments,  processing  payroll  and  other  administrative  functions,  etc.  A  significant  disruption  or  failure  of  our  information
technology  systems  may  have  a  significant  impact  on  our  operations,  potentially  resulting  in  service  interruptions,  security  violations,  regulatory  compliance
failures and other operational difficulties. In addition, any attack perpetrated against our information systems including through a system failure, security breach or
disruption  by  malware  or  other  damage,  could  similarly  impact  our  operations  and  result  in  loss  or  misuse  of  information,  litigation  and  potential  liability.
Although we have taken steps intended to mitigate the risks presented by potential cyber incidents, it is not possible to protect against every potential power loss,
telecommunications  failure,  cybersecurity  attack  or  similar  event  that  may  arise.  Moreover,  the  safeguards  we  use  are  subject  to  human  implementation  and
maintenance and to other uncertainties. Any of these cyber incidents may result in a violation of applicable laws or regulations (including privacy and other laws),
damage our reputation, cause a loss of customers and give rise to monetary fines and other penalties, which could be significant. Such events could have an adverse
effect on our results of operations, financial condition and liquidity.

There are risks related to the implementation of our new global enterprise resource planning system.

We are currently engaged in a multi-year process of conforming our financial and accounting data onto a new enterprise resource planning system ("ERP"). The
ERP is designed to improve the efficiency of our financial transaction processes, accurately maintain our books and records, and provide information important to
the  operation  of  the  business  to  our  management  team.  The  implementation  of  the  ERP  will  continue  to  require  significant  investment  of  human  and  financial
resources, and we may experience delays and increased costs as a result. Any significant disruption or deficiency in the design and implementation of the ERP
could have a material adverse effect on our ability to fulfill and invoice customer orders, apply cash receipts, place purchase orders with suppliers, and make cash
disbursements, and could negatively impact data processing, which may have a material adverse effect on our business, consolidated financial condition or results
of operations. While we have invested significant resources in planning and project management, significant implementation issues may arise.

Item 1B.     Unresolved Staff Comments.

None.

Item 2.     Properties.

We lease our corporate offices, located at 3220 Tillman Drive, Bensalem, Pennsylvania 19020. We also lease office space at other locations in Colorado, South
Carolina, Connecticut, Georgia, California and New Jersey. The New Jersey office is the headquarters of our wholly-owned subsidiaries. The other locations serve
as divisional or regional offices providing management and administrative services to both of our operating segments in their respective geographical areas.

We are also provided with office and storage space at each of our clients’ facilities.

Management  does  not  foresee  any  difficulties  with  regard  to  the  continued  utilization  of  these  premises.  We  also  believe  that  such  properties  are  sufficient  to
support our current operations.

We own office furniture and equipment, housekeeping and laundry equipment, and vehicles. The office furniture and equipment and vehicles are primarily located
at  the  corporate  office,  divisional  and  regional  offices.  We  have  housekeeping  equipment  at  all  client  facilities  where  we  provide  services  under  a  full  service
housekeeping agreement. Generally, the aggregate cost of housekeeping equipment located at each client facility is approximately $3,000. Additionally, we have
laundry  installations  at  certain  client  facilities.  The  cost  of  such  laundry  installations  ranges  between  $5,000  and  $100,000.  We  believe  that  such  laundry
equipment, office furniture and equipment, housekeeping equipment and vehicles are sufficient to support our current operations.

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Table of Contents

Item 3.     Legal Proceedings.

In the normal course of business, the Company is involved in various administrative and legal proceedings, including labor and employment, contractual, personal
injury,  workers  compensation  and  insurance  matters.  We  believe  the  Company  is  not  a  party  to,  nor  are  any  of  its  properties  the  subject  of,  any  pending  legal
proceeding or governmental examination that would have a material adverse effect on our consolidated financial condition or liquidity. However, in light of the
uncertainties involved in such proceedings, the ultimate outcome of a particular matter could become material to our results of operations for a particular period
depending on, among other factors, the size of the loss or liability imposed and the level of our operating income for that period.

Item 4.   Mine Safety Disclosures.

Not applicable.

14

Table of Contents

Item 5.     Market for Registrant’s Common Equity,   Related Stockholder Matters and Issuer   Purchases of Equity Securities.

Market Information

PART II

The  Company’s  Common  Stock,  $0.01  par  value  (the  “Common  Stock”),  is  traded  under  the  symbol  “HCSG”  on  the  NASDAQ  Global  Select  Market.  As  of
March 14, 2019, there were approximately 74.0 million shares of our Common Stock outstanding.

Holders

As of March 14, 2019, we had approximately 400 holders of record of our Common Stock. Based on reports of security position listings compiled for the 2018
annual meeting of shareholders, we believe we may have approximately 8,000 beneficial owners of our Common Stock.

Securities Authorized for Issuance Under Equity Compensation Plans

The  following  table  sets  forth  for  the  Company’s  equity  compensation  plans,  on  an  aggregated  basis,  the  number  of  shares  of  our  Common  Stock  subject  to
outstanding  stock  awards,  the  weighted-average  exercise  price  of  stock  awards,  and  the  number  of  shares  remaining  available  for  future  award  grants  as  of
December 31, 2018.

Number of Securities to be Issued
Upon Exercise of Outstanding
Options, Warrants and Rights 
(a)

Weighted-Average Exercise
Price of Outstanding Options,
Warrants and Rights 
(b)

Number of Securities Remaining
Available for Future Issuance
Under Equity Compensation Plans
(Excluding Securities Issued and
not Exercised)
(c)

(in thousands, except per share amounts)

2,121  1  $

— 

2,121 

$

31.53 

— 

31.53 

3,119  2 

— 

3,119 

Plan Category

Equity compensation plans approved by security holders

Equity compensation plans not approved by security holders

Total

1 

2 

Represents shares of Common Stock issuable upon exercise of outstanding stock awards granted under the 2012 Equity  Incentive Plan and carryover shares from pre-
existing Plans.
Includes  stock  awards  to  purchase  0.5  million  shares  available  for  future  grant  under  the  Company’s  2012  Plan  (the  "2012  Plan"),  2.2  million  shares  available  for
issuance under the Company’s 1999 Employee Stock Purchase Plan (the “1999 Plan”) as amended and 0.4 million shares available for issuance under the Company’s
Amended  and  Restated  Deferred  Compensation  Plan  (the  "Deferred  Compensation  Plan").  Treasury  shares  may  be  issued  under  the  1999  Plan  and  the  Company’s
Amended and Restated Deferred Compensation Plan.

Performance Graph

The following graph matches Healthcare Services Group, Inc.’s cumulative five-year total shareholder return on Common Stock with the cumulative total returns
of the S&P 500 index, the NASDAQ Composite index and the Russell 2000 index. The graph tracks the performance of a $100 investment in our Common Stock
and in each index (with the reinvestment of all dividends) from December 31, 2013 to December 31, 2018. The stock price performance included in this graph is
not necessarily indicative of future stock price performance.

We have not defined a peer group based on either industry classification or financial characteristics. We believe the Company is unique in its service offerings and
client  base,  and  among  its  closest  industry  peers,  it  is  unique  in  size  and  financial  profile.  As  such,  we  opted  to  utilize  the  Russell  2000  index  to  compare  the
Company performance to issuers with similar market capitalization.

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Table of Contents

Comparison of 5 Year Cumulative Total Return*

Among Healthcare Services Group, Inc., the S&P 500 Index, the NASDAQ Composite Index and the Russell 2000 Index

*$100 invested on December 31, 2013 in stock or index, including reinvestment of dividends.
Fiscal year ending December 31.

Copyright© 2019 Standard & Poor’s, a division of S&P Global. All rights reserved.
Copyright© 2019 Russell Investment Group. All rights reserved.

Company/Index
Healthcare Services Group, Inc.

S&P 500

Russell 2000

NASDAQ Composite

2013 

2014 

2015 

2016 

2017 

2018

$

$

$

$

100.00  $

100.00  $

100.00  $

100.00  $

111.71  $

113.69  $

104.89  $

114.62  $

128.64  $

115.26  $

100.26  $

122.81  $

147.39  $

129.05  $

121.63  $

133.19  $

201.58  $

157.22  $

139.44  $

172.11  $

156.45 

150.33 

124.09 

165.84 

December 31,

Unregistered Sales of Equity Securities and Use of Proceeds

None

16

Table of Contents

Item 6.     Selected Financial Data.

The  following  selected  condensed  consolidated  financial  data  has  been  derived  from,  and  should  be  read  in  conjunction  with  “Management’s  Discussion  and
Analysis  of  Financial  Condition  and  Results  of  Operations”  and  our  Consolidated  Financial  Statements  and  Notes  thereto,  included  elsewhere  in  this  report  on
Form 10-K and incorporated herein by reference.

Selected Operating Results 

Revenues

Net income

Basic earnings per common share

Diluted earnings per common share

Selected Balance Sheet Data 

Total assets

Stockholders’ equity

Selected Other Financial Data 

Working capital

Cash dividends declared per common share

Weighted average number of common shares outstanding -
basic

Weighted average number of common shares outstanding -
diluted

2018

2017

2016

2015

2014

(in thousands, except per share amounts)

Years Ended December 31, 

$

$

$

$

$

$

$

$

2,008,821  $

1,866,131  $

1,562,662  $

1,436,849  $

1,293,183 

83,524  $

88,226  $

77,396  $

58,024  $

1.13  $

1.12  $

1.20  $

1.19  $

1.06  $

1.05  $

0.81  $

0.80  $

692,603  $

440,780  $

676,003  $

399,952  $

528,446  $

338,842  $

480,949  $

296,456  $

344,745  $

0.7775  $

343,238  $

0.7575  $

313,753  $

0.7375  $

269,277  $

0.7175  $

74,002 

74,612 

73,355 

74,348 

72,754 

73,474 

71,826 

72,512 

21,850 

0.31 

0.31 

469,579 

275,830 

213,414 

0.6975 

70,616 

71,341 

Item 7.     Management’s Discussion and Analysis   of Financial Condition and Results of   Operation.

You
should
read
the
following
discussion
and
analysis
of
our
financial
condition
and
results
of
our
operations
in
conjunction
with
our
Consolidated
Financial
Statements
and
the
related
notes
to
those
statements
included
elsewhere
in
this
report.
This
discussion
contains
forward-looking
statements
reflecting
our
current
expectations
that
involve
risks
and
uncertainties.
Our
actual
results
and
the
timing
of
events
may
differ
materially
from
those
contained
in
these
forward-looking
statements
due
to
a
number
of
factors,
including
those
discussed
in
the
section
entitled
“Risk
Factors,”
and
elsewhere
in
this
report
on
Form
10-K.
We
are
on
a
calendar
year
end,
and
except
where
otherwise
indicated,
“2018”
refers
to
the
year
ended
December
31,
2018,
“2017”
refers
to
the
year
ended
December
31,
2017
and
“2016”
refers
to
the
year
ended
December
31,
2016.

Results of Operations

The following discussion is intended to provide the reader with information that will be helpful in understanding our financial statements, including the changes in
certain key items in comparing financial statements period to period. We also intend to provide the primary factors that accounted for those changes, as well as a
summary  of  how  certain  accounting  principles  affect  our  financial  statements.  In  addition,  we  are  providing  information  about  the  financial  results  of  our  two
operating segments to further assist in understanding how these segments and their results affect our consolidated results of operations. This discussion should be
read in conjunction with our financial statements as of December 31, 2018 and for the year then ended and the notes accompanying those financial statements.

Overview

We  provide  management,  administrative  and  operating  expertise  and  services  to  the  housekeeping,  laundry,  linen,  facility  maintenance  and  dietary  service
departments of healthcare facilities, including nursing homes, retirement complexes, rehabilitation centers and hospitals located throughout the United States. We
believe we are the largest provider of housekeeping and laundry management services to the long-term care industry in the nation, rendering such services to over
3,500 facilities throughout the continental United States as of December 31, 2018. 

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We provide services primarily pursuant to full service agreements with our clients. Under such agreements, we are responsible for the day-to-day management of
the employees located at our clients’ facilities, as well as the provision of certain supplies. We also provide services on the basis of management-only agreements
for a limited number of clients. Under a management-only agreement, we provide management and supervisory services while the client facility retains payroll
responsibility for the non-supervisory staff. Our agreements with clients typically provide for a renewable one year service term, cancelable by either party upon 30
to 90 days’ notice after an initial period of 60 to 120 days. 

We are organized into two reportable segments: housekeeping, laundry, linen and other services (“Housekeeping”) and dietary department services (“Dietary”). 

Housekeeping  consists  of  managing  our  clients’  housekeeping  departments,  which  are  principally  responsible  for  the  cleaning,  disinfecting  and  sanitizing  of
resident rooms and common areas of the clients’ facilities, as well as the laundering and processing of the bed linens, uniforms, resident personal clothing and other
assorted linen items utilized at the clients’ facilities. Upon beginning service with a client facility, we typically hire and train the employees previously employed
by  such  facility  and  assign  an  on-site  manager  to  supervise  and  train  the  front-line  personnel  and  coordinate  housekeeping  services  with  other  facility  support
functions  in  accordance  with  client  requests.  Such  management  personnel  also  oversee  the  execution  of  various  cost  and  quality-control  procedures  including
continuous training and employee evaluation, and on-site testing for infection control. 

Dietary consists of managing our clients’ dietary departments, which are principally responsible for food purchasing, meal preparation and professional dietitian
services,  which  include  the  development  of  menus  that  meet  the  dietary  needs  of  residents.  On-site  management  is  responsible  for  all  daily  dietary  department
activities,  with regular  support  provided  by a District  Manager  specializing  in dietary  services.  We also offer  clinical  consulting  services  to our dietary  clients,
which may be provided as a stand-alone service, or bundled with other dietary department services. Upon beginning service with a client facility, we typically hire
and train the employees previously employed by such facility and assign an on-site manager to supervise and train the front-line personnel and coordinate dietitian
services  with  other  facility  support  functions  in  accordance  with  client  requests.  Such  management  personnel  also  oversee  the  execution  of  various  cost  and
quality-control procedures including continuous training and employee evaluation. 

At December 31, 2018, Housekeeping services were provided at essentially all of our more than 3,500 client facilities, generating approximately 48.5%, or $973.8
million,  of  2018  total  revenues.  Dietary  services  were  provided  to  over  1,500  client  facilities  at  December  31,  2018  and  contributed  approximately  51.5%,  or
$1,035.0 million, of 2018 total revenues.

Our  workers’  compensation,  general  liability  and  certain  employee  health  and  welfare  insurance  programs  are  provided  by  HCSG  Insurance  Corp.  (“HCSG
Insurance” or the “Captive”), our wholly-owned captive insurance subsidiary. HCSG Insurance provides the Company with greater flexibility and cost efficiency
in meeting our insurance needs. In 2015, we completed a corporate restructuring by capitalizing three new operating entities and transitioning our facility-based
employees to such entities based on the geography served. HCSG Insurance provides workers’ compensation, general liability and other insurance coverages to
such  entities  with  respect  to  such  transitioned  workforce,  such  entities  provide  housekeeping,  laundry  and  dietary  services  as  a  subcontracted  provider  to  the
Company, and the Company provides strategic client-service management and administrative support services to such entities.

Our ability to acquire new clients, retain existing clients and increase revenues are affected by many factors. Competitive factors consist primarily of competing
with  potential  clients’  use  of  in-house  support  staff,  as  well  as  local  or  regional  companies  providing  services  similar  to  ours.  We  are  unaware  of  any  other
companies, on a national, regional or local level, which have a significant presence or will impact our ability to secure new clients in our market. We believe the
primary  revenue  drivers  of our  business  are  our  ability  to obtain  new  clients  and  to  provide  additional  services  to  existing  clients.  In  addition,  we seek  to  pass
through, by means of service billing increases, increases in our cost of providing the services, while also aiming to obtain modest annual revenue increases from
our existing clients to attain desired profit margins at the facility level. The primary economic factor in acquiring new clients is our ability to demonstrate the cost-
effectiveness of our services, because many of our clients’ revenues are generally highly reliant on Medicare and Medicaid reimbursements. Therefore, our clients’
economic  decision-making  is  driven  significantly  by  their  reimbursement  funding  rate  structure  and  the  financial  impact  on  their  reimbursement  as  a  result  of
engaging  us  for  the  respective  services.  The  primary  operational  factor  is  our  ability  to  demonstrate  to  potential  clients  the  benefits  of  being  relieved  of  the
administrative  and  operational  challenges  related  to  the  day-to-day  management  of  their  housekeeping  and  dietary  operations.  In  addition,  we  must  be  able  to
assure  new  clients  that  we  can  improve  the  quality  of  service  that  they  are  providing  to  their  residents.  We  believe  the  factors  discussed  above  are  equally
applicable to each of our segments with respect to acquiring new clients and increasing revenues.

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When evaluating financial performance, we consider the ratio of certain financial items to consolidated revenues. The table below summarizes those metrics for
2018, 2017 and 2016:  

Revenues

Operating costs and expenses:

Costs of services provided

Selling, general and administrative

Net investment and interest income

Income before income taxes

Income taxes

Net income

Relation to Consolidated Revenues 
Years Ended December 31, 

2018

2017

2016

100.0 %

100.0 %

100.0 %

88.2 %

6.8 %

0.0%

5.0 %

0.8 %

4.2 %

86.4 %

6.8 %

0.3 %

7.1 %

2.4 %

4.7 %

85.7 %

6.7 %

0.2 %

7.8 %

2.8 %

5.1 %

Subject  to  the  factors  noted  in  the  "Cautionary  Statement  Regarding  Forward  Looking  Statements"  included  in  this  report  on  Form  10-K,  we  expect  that  our
consolidated financial performance in 2019 may be comparable to the historical ratios above, absent the effects of adjustments to our bad debt expense and self-
insurance reserves in costs of services provided and the change in the provision for income taxes. We anticipate that for 2019, Dietary revenues will continue to
increase as a percentage of consolidated revenues by expanding upon the services performed for our current Housekeeping client base. Our expected growth in
Housekeeping will primarily come from obtaining new clients.

Our  costs  of  services  can  vary  and  may  impact  our  operating  performance.  Management  reviews  two  key  indicators  (costs  of  labor  and  costs  of  supplies  as
percentages of segment revenues) to monitor and manage such costs. The variability of these costs may impact each segment differently, as Housekeeping is more
significantly  impacted  by  costs  of  labor  than  Dietary.  Labor  costs  accounted  for  approximately  78.8%  of  Housekeeping  revenues  in  2018.  Dietary  labor  costs
accounted for approximately 57.2% of Dietary revenues in 2018. Changes in wage rates as a result of legislative or collective bargaining actions, market factors,
adjustments to staffing levels, and other variations in our use of labor or in management labor costs can result in variability of these costs. Housekeeping supplies,
including linen products, accounted for approximately 7.8% of Housekeeping revenues in 2018. In contrast, supplies consumed in performing our Dietary services
accounted  for  approximately  34.4%  of  Dietary  revenues.  Generally,  fluctuations  in  these  expenses  are  influenced  by  factors  outside  of  our  control  and  are
unpredictable. Housekeeping and Dietary supplies are principally commodity products and are affected by market conditions specific to the respective products.

Our clients are concentrated in the healthcare industry and are primarily providers of long-term care. Many of our clients’ revenues are highly reliant on Medicare,
Medicaid and third-party payors’ reimbursement funding rates. Legislation can significantly alter overall government reimbursement for nursing home services and
such changes, as well as other trends in the long-term care industry, have affected and could adversely affect our clients’ cash flows, resulting in their inability to
make payments to us in accordance with agreed-upon payment terms. The climate of legislative uncertainty has posed, and will continue to pose, both risks and
opportunities for us: the risks are related to our clients’ cash flows and solvency, while the opportunities are related to our ability to offer our clients cost stability
and efficiencies.

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Table of Contents

Years Ended December 31, 2018 and 2017  

The  following  table  sets  forth  the  2018  income  statement  key  components  that  we  use  to  evaluate  our  financial  performance  on  a  consolidated  and  reportable
segment  basis  compared  to  2017.  The  differences  between  the  reportable  segments’  operating  results  and  other  disclosed  data  and  our  Consolidated  Financial
Statements relate primarily to corporate level transactions and adjustments related to transactions recorded at the reportable segment level which use methods other
than generally accepted accounting principles.

Revenues 

Housekeeping  

Dietary 

Consolidated 

Costs of services provided 

Housekeeping  

Dietary  

Corporate and eliminations 

Consolidated 

Selling, general and administrative expense 

Corporate and eliminations 

Investment and interest income 
Corporate and eliminations 

Income (loss) before income taxes 

Housekeeping  

Dietary 

Corporate and eliminations 

Consolidated 

Income taxes 

Corporate and eliminations 

Revenues

Consolidated

2018 

Year Ended December 31, 

2017 

(in thousands)

% Change 

973,826  $

1,034,995 

2,008,821  $

865,521  $

974,433 

(67,973)

1,771,981  $

979,610 

886,521 

1,866,131 

884,105 

840,513 

(112,108)

1,612,510 

(0.6)%

16.7 %

7.6 %

(2.1)%

15.9 %

(39.4)%

9.9 %

136,603  $

126,732 

7.8 %

(327) $

6,076 

(105.4)%

108,305  $

60,562 

(68,957)

99,910  $

95,505 

46,008 

(8,548)

132,965 

13.4 %

31.6 %

706.7 %

(24.9)%

16,386  $

44,739 

(63.4)%

$

$

$

$

$

$

$

$

$

Consolidated  revenues  increased  7.6%  to  $2.0  billion  in  2018  compared  to  $1.9  billion  in  2017  as  a  result  of  the  factors  discussed  below  under  Reportable
Segments.

Reportable
Segments

Housekeeping’s  0.6%  decrease  in  reportable  segment  revenues  resulted  primarily  from  adjustments  during  2018  to  our  contractual  relationships  with  multiple
regional customers as well as a number of independent facilities. Dietary’s 16.7% increase in reportable segment revenues resulted primarily from providing these
services to a greater number of existing Housekeeping clients.

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Table of Contents

Costs of services provided

Consolidated

Consolidated costs of services increased 9.9% to $1.8 billion in 2018 compared to $1.6 billion in 2017, primarily related to our overall growth, as represented by
our 7.6% growth in consolidated revenues for the same period. As a percentage of consolidated revenues, cost of services increased   to 88.2% in 2018 from 86.4%
in 2017.

Certain significant components within our costs of services are subject to fluctuation with changes in our business and client base. Labor and other labor-related
costs,  dining  and  housekeeping  supplies,  and  self-insurance  costs  account  for  most  of  our  consolidated  costs  of  services.  See  the  discussion  under  Reportable
Segments below for additional information on the changes in the components of costs of services.

The following table provides a comparison of the key indicators we consider when managing the consolidated cost of services provided:

Costs of Services Provided - Key Indicators as % of Consolidated Revenue 
Bad debt provision

Self-insurance costs

Year Ended December 31,

2018
2.6% 

1.9% 

2017
0.3% 

2.4% 

% Change
2.3% 

(0.5)%

The increase to our bad debt provision for 2018  related to multiple corporate restructurings of privately-held, multi-facility operators that occurred during 2018
that resulted in increased expense compared to our historical experience.

The decrease in self-insurance costs as a percentage of consolidated revenue is primarily the result of the Company’s ongoing initiatives to promote safety and
accident prevention in the workplace, as well as proactive management of workers’ compensation claims, which have positively impacted our claims experience.

Reportable
Segments

Costs  of  services  provided  for  Housekeeping,  as  a  percentage  of  Housekeeping  revenues  for  2018,  decreased  to  88.9%  compared  to  90.3%  in  2017.  Cost  of
services provided for Dietary, as a percentage of Dietary revenues for 2018, decreased to 94.1% compared to 94.8% in 2017.

The following table provides a comparison of the key indicators we consider when managing cost of services at the segment level, as a percentage of the respective
segment’s revenues:

Costs of Services Provided - Key Indicators as % of Segment Revenue 
Housekeeping labor and other labor-related costs

Housekeeping supplies

Dietary labor and other labor-related costs

Dietary supplies

2018
78.8% 

7.8% 

57.2% 

34.4% 

Year Ended December 31,

2017
80.1% 

8.0% 

56.6% 

36.1% 

% Change
(1.3)%

(0.2)%

0.6% 

(1.7)%

The ratios of these key indicators generally remain relatively consistent. Variations in these ratios can relate to changes in the mix of clients for whom we provide
supplies or do not provide supplies. Management focuses on building efficiencies based on our operational expertise, managing labor and labor-related costs, as
well as managing supply chain costs by leveraging economies of scale. 

Consolidated Selling, General and Administrative Expense  

Excluding  the  change  in  the  deferred  compensation  plan  described  below,  consolidated  selling,  general  and  administrative  expense  for  2018  increased  $15.9
million or 13.0% compared to 2017, related to our overall growth, a $3 million, state-specific sales tax settlement and ongoing investments in technology.

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Included in selling, general and administrative expense are gains and losses associated with changes in the value of investments under the deferred compensation
plan. These investments represent the amounts held on behalf of the participating employees and changes in the value of these investments affect the amount of our
deferred compensation liability . Losses on the plan investments during 2018 decreased our selling, general and administrative expense for the year. Gains on the
plan investments during 2017 increased our selling, general and administrative expense for the year.

Selling, general and administrative expense excluding change in
deferred compensation liability

(Loss) gain on deferred compensation plan investments

Selling, general and administrative expense

$

$

138,072  $

(1,469)

136,603  $

(in thousands) 

122,198  $

4,534 

126,732  $

15,874 

(6,003)

9,871 

13.0 %

(132.4)%

7.8 %

2018

2017

% Change 

% Change

Year Ended December 31,

Consolidated Investment and Net Interest Income

Investment and interest income decreased 105.4% for 2018 compared to 2017, primarily due to higher interest costs associated with our short–term borrowings
and unfavorable market fluctuations in the value of our trading security investments representing the funding for our deferred compensation plan.

Consolidated Income Taxes

Our effective tax rate was 16.4% for 2018 compared to 33.6% for 2017. On December 22, 2017, the U.S. enacted the Tax Cuts and Jobs Act (the "Act"), which
lowered our U.S. statutory federal income tax rate from 35% to 21% effective January 1, 2018.

Differences between our effective tax rates and the applicable U.S. federal statutory rate arise primarily from the effects of state and local taxes and tax credits
available to the Company. We participate in the Work Opportunity Tax Credit (“WOTC”) program, through which the Company receives tax credits for hiring and
retaining employees from target groups with significant barriers to employment. This credit is currently scheduled to expire on December 31, 2019.

Additionally, the Company recognized a deferred tax asset of $13.0 million during 2018 which was primarily driven from the impact of the Company's provision
for bad debt during the period and contributed to the difference between our effective tax rates and the applicable U.S. federal statutory rate.

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Years Ended December 31, 2017 and 2016  

The following table sets forth 2017 income statement key components that we use to evaluate our financial performance on a consolidated and reportable segment
basis compared to 2016. The differences between the reportable segments’ operating results and other disclosed data and our Consolidated Financial Statements
relate  primarily  to  corporate  level  transactions  and  adjustments  related  to  transactions  recorded  at  the  reportable  segment  level  which  use  methods  other  than
generally accepted accounting principles.

Revenues 

Housekeeping  

Dietary 

Consolidated 

Costs of services provided 

Housekeeping  

Dietary  

Corporate and eliminations 

Consolidated 

Selling, general and administrative expense 

Corporate and eliminations 

Investment and interest income 
Corporate and eliminations 

Income (loss) before income taxes 

Housekeeping  

Dietary 

Corporate and eliminations 

Consolidated 

Income taxes 

Corporate and eliminations 

Revenues

Consolidated

2017 

Year Ended 

2016 

(in thousands)

% Change 

979,610  $

886,521 

1,866,131  $

884,105  $

840,513 

(112,108)

957,148 

605,514 

1,562,662 

866,392 

570,873 

(97,773)

1,612,510  $

1,339,492 

2.3 %

46.4 %

19.4 %

2.0 %

47.2 %

14.7 %

20.4 %

126,732  $

105,417 

20.2 %

6,076  $

2,634 

130.7 %

95,505  $

46,008 

(8,548)

132,965  $

90,756 

34,641 

(5,010)

120,387 

5.2 %

32.8 %

70.6 %

10.4 %

44,739  $

42,991 

4.1 %

$

$

$

$

$

$

$

$

$

Consolidated  revenues  increased  19.4%  to  $1.9  billion  in  2017  compared  to  $1.6  billion  in  2016  as  a  result  of  the  factors  discussed  below  under  Reportable
Segments.

Reportable
Segments

Housekeeping’s 2.3% increase in reportable segment revenues resulted primarily from service agreements entered into with new clients.

Dietary’s 46.4% increase in reportable segment revenues resulted primarily from providing these services to a greater number of existing Housekeeping clients.

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Table of Contents

Costs of services provided

Consolidated

Consolidated costs of services increased 20.4% to $1.6 billion in 2017 compared to $1.3 billion in 2016. The increase in costs of services is primarily related to our
overall  growth,  as  represented  by  our  19.4%  growth  in  consolidated  revenues  for  the  same  period.  As  a  percentage  of  consolidated  revenues,  cost  of  services
increased   to 86.4% in 2017 from 85.7% in 2016.

Certain significant components within our costs of services are subject to fluctuation with the changes in our business and client base. Labor and other labor-related
costs,  dining  and  housekeeping  supplies,  and  self-insurance  costs  account  for  most  of  our  consolidated  costs  of  services.  See  the  discussion  under  Reportable
Segments below for additional information on the changes in the components of costs of services.

The following table provides a comparison of the key indicators we consider when managing the consolidated cost of services:

Costs of Services Provided - Key Indicators as % of Consolidated Revenue 
Bad debt provision

Self-insurance costs

Year Ended December 31,

2017
0.3% 

2.4% 

2016
0.3% 

3.0% 

% Change 
—%

(0.6)%

The bad debt provision remained consistent due to our assessment of the collectability of our accounts and notes receivables.

The decrease in self-insurance costs as a percentage of consolidated revenue is primarily the result of the Company’s ongoing initiatives to promote safety and
accident prevention in the workplace, as well as proactive management of workers’ compensation claims, which positively impact our claims experience.

Reportable
Segments

Costs  of  services  provided  for  Housekeeping,  as  a  percentage  of  Housekeeping  revenues  for  2017,  decreased  to  90.3%  compared  to  90.5%  in  2016.  Costs  of
services provided for Dietary, as a percentage of Dietary revenues for 2017, increased to 94.8% compared to 94.3% in 2016.

The following table provides a comparison of the key indicators we consider when managing cost of services at the segment level, as a percentage of the respective
segment’s revenues:

Costs of Services Provided - Key Indicators as % of Segment Revenue 
Housekeeping labor and other labor costs

Housekeeping supplies

Dietary labor and other labor costs

Dietary supplies

2017
80.1% 

8.0% 

56.6% 

36.1% 

Year Ended December 31,

2016
80.2% 

7.8% 

53.8% 

38.0% 

% Change 
(0.1)%

0.2% 

2.8% 

(1.9)%

The  ratios  of  these  key  indicators  generally  remain  relatively  consistent.  However,  during  this  period  of  high-growth,  the  Company  has  experienced  some
inefficiencies  when  integrating  new  business  and  facilities.  Such  inefficiencies  can  relate  to  standardizing  work  flows  and  labor  resources,  establishing
administrative structures, provisioning and other operational and logistical activities. Further, variations in these ratios can relate to changes in the mix of clients
for whom we provide supplies or do not provide supplies. Management focuses on building efficiencies based on our operational expertise, managing labor and
labor-related costs, as well as managing supply chain costs by leveraging economies of scale.

Consolidated Selling, General and Administrative Expense  

Excluding  the  change  in  the  deferred  compensation  plan,  consolidated  selling,  general  and  administrative  expense  for  2017  increased  $18.3  million  or  17.6%
compared to 2016, related primarily to our overall growth.

Included in selling, general and administrative expense are gains and losses associated with changes in the value of investments under the deferred compensation
plan. These investments represent the amounts held on behalf of the participating employees and changes in the value of these investments affect the amount of our
deferred compensation liability . Gains on the plan investments during 2017 and 2016 increased our selling, general and administrative expense for these periods.

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Selling, general and administrative expense excluding change in deferred
compensation liability

Gain on deferred compensation plan investments

Selling, general and administrative expense

$

$

122,198  $

103,922  $

4,534 

1,495 

126,732  $

105,417  $

18,276 

3,039 

21,315 

17.6 %

203.3 %

20.2 %

Year Ended December 31,

2017

2016

$ Change

% Change

(in thousands)

Consolidated Investment and Net Interest Income

Investment and interest income increased 130.7% for 2017 compared to 2016, primarily due to favorable market fluctuations in the value of our trading security
investments representing the funding for our deferred compensation plan.

Consolidated Income Taxes

Our effective tax rate was 33.6% for 2017 and 35.7% for 2016. Changes in the accounting for the effects of income taxes took place during 2017, which impacted
our  effective  tax  rate.  In  2017,  the  Company  adopted  Accounting  Standards  Update  (“ASU”)  2016-09,  under  which  excess  tax  benefits  related  to  share-based
payments were recognized as a component of income tax expense, as opposed to additional paid-in capital, resulting in a decrease in 2017 income tax expense. In
addition, in December 2017 the Act was signed into law, enacting significant changes to corporate tax rates, as well as business-related exclusions, deductions and
credits.

During 2017, the Company recognized the effects of the changes in the tax law and rates on its deferred tax balances. The net result of the remeasurement was an
approximate $4.5 million decrease to the Company’s net deferred tax assets balance and a corresponding increase to the Company’s provision for income taxes.
Excluding the effects of ASU 2016-09 and the Act, our estimated effective tax rate would have approximated 33.9%.

Critical Accounting Policies and Estimates

The preparation of financial statements in accordance with accounting standards generally accepted in the United States (“U.S. GAAP”) requires management to
make  estimates  and  assumptions  that  affect  the  reported  amounts  of  assets  and  liabilities  at  the  date  of  the  financial  statements  and  the  reported  amounts  of
revenues and expenses during the reporting period.

Financial reporting results rely on estimating the effects of matters that are inherently uncertain. An understanding of the policies discussed below is critical to the
understanding  of  our  financial  statements  because  the  application  of  these  policies  requires  judgment.  Specific  risks  for  these  critical  accounting  policies  and
estimates are described in the following paragraphs. For these estimates, we caution that future events do not always occur as forecasted, and the best estimates
routinely require adjustment. Any such adjustments or revisions to estimates could result in material differences from previously reported amounts.

The policies discussed below are not intended to be a comprehensive list of all of our accounting policies. In many cases, the accounting treatment of a particular
transaction  is  specifically  dictated  by  U.S. GAAP, with  no  need  for  our  judgment  in  their  application.  There  are  also  areas  in  which  our  judgment  in  selecting
another available alternative would not produce a materially different result. See our audited consolidated financial statements and notes thereto which are included
in this Annual Report on Form 10-K, which contain a discussion of our accounting policies and other disclosures required by U.S. GAAP.

Allowance for Doubtful Accounts

The  allowance  for  doubtful  accounts  (the  “Allowance”)  is  established  as  losses  are  estimated  to  have  occurred  through  a  provision  for  bad  debts  charged  to
earnings. The Allowance is evaluated based on our ongoing review of accounts and notes receivable and is inherently subjective as it requires estimates that are
susceptible to significant revision as more information becomes available.

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We have had varying collections experience with respect to our accounts and notes receivable. We have at times elected to extend the period of payment for certain
clients beyond contractual terms. Such clients include those who have terminated service agreements and slow payers experiencing financial difficulties. In making
credit evaluations, in addition to analyzing and anticipating, where possible, the specific cases described above, we consider customer-specific risks as well as the
general collection risks associated with trends in the long-term care industry. We establish credit limits, perform ongoing credit evaluations, and monitor accounts
to minimize the risk of loss.

We regularly evaluate our accounts and notes receivable for impairment or loss of value and when appropriate, we will record an Allowance for such receivables.
We generally follow a policy of partially reserving for receivables due from clients in bankruptcy, clients with which we are in litigation for collection and other
slow  paying  clients.  The  Allowance  is  adjusted  as  additional  information  becomes  available  to  more  accurately  estimate  collectability.  If  the  amount  of  our
recovery of a receivable is determined, through litigation, bankruptcy proceedings or negotiation, to be less than the amount recorded on our balance sheet, we will
charge the applicable amount to the Allowance.

Summarized below for the years 2018, 2017 and 2016 are the aggregate account balances against which reserves were recorded, as well as net write-offs, the bad
debt provision and the balance of the allowance for doubtful accounts:

Year Ended 

2018

2017

2016

$

$

$

Aggregate Account Balances of Clients in
Bankruptcy or in/or Pending
Collection/Litigation 

Net Write-offs of Client
Accounts 

(in thousands) 

Bad Debt Provision 

Allowance for Doubtful
Accounts 

115,659  $

30,035  $

15,873  $

6,163  $

1,176  $

2,326  $

51,387  $

6,250  $

4,629  $

57,209 

11,985 

6,911 

Actual collections of these accounts could differ from our current estimate. If our actual collection experience is 5% less than our estimate, the related increase to
our  Allowance  would  decrease  net  income  by  approximately  $2.4  million.  Despite  our  efforts  to  minimize  credit  risk  exposure,  our  clients  could  be  adversely
affected if future industry trends, as more fully discussed under Liquidity and Capital Resources below, and in this Annual Report on Form 10-K in Part I under
“Risk Factors,” “Government Regulation of Clients” and “Service Agreements and Collections,” change in such a manner as to negatively impact the cash flows of
our  clients.  If  our  clients  experience  a  negative  impact  in  their  cash  flows,  it  could  have  a  material  adverse  effect  on  our  results  of  operations  and  financial
condition.

Accrued Insurance Claims

We currently have a Paid Loss Retrospective Insurance Plan for general liability and workers’ compensation insurance, which comprise approximately 31.6% of
our liabilities at December 31, 2018. Under our insurance plans for general liability and workers’ compensation, predetermined loss limits are arranged with our
insurance company to limit both our per occurrence cash outlay and annual insurance plan cost. Our accounting for this plan utilizes current valuations from a third
party actuary, which include assumptions based on data such as historical claims and pay-out experience, demographic factors, industry trends, severity factors,
and other actuarial calculations. In the event that our claims experience and/or industry trends result in an unfavorable change in our assumptions or outcomes, it
would have an adverse effect on our results of operations and financial condition. Recently, our claims experiences have been favorable, as a result of our ongoing
initiative to promote safety and accident prevention in the workplace, as well as proactive management of workers’ compensation claims.

For general liability and workers’ compensation, we record both a reserve for the estimated future cost of claims and related expenses that have been reported but
not settled, as well as an estimate of claims incurred but not reported. Such reserves for claims incurred but not reported are developed by a third party actuary
through review of our historical data and open claims.

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A summary of the changes in our total self-insurance liability is as follows:

Accrued insurance claims - January 1,

Claim payments

Reserve accruals:

Current year accruals

Changes to the provision for prior year claims

Change in accrued insurance claims

Accrued insurance claims - December 31,

Asset Valuations and Review for Potential Impairment

2018

2017

(in thousands) 

2016

84,699  $

(34,901)

87,653  $

(41,077)

45,478 

(15,676)

(5,099)

49,673 

(11,550)

(2,954)

79,600  $

84,699  $

82,250 

(35,089)

42,592 

(2,100)

5,403 

87,653 

$

$

We review our fixed assets, deferred income taxes, goodwill and other intangible assets at least annually or whenever events or circumstances indicate that their
carrying amounts may not be recoverable. This review requires that we make assumptions regarding the fair value of these assets and the changes in circumstances
that would affect the carrying value of these assets. If the carrying value of an asset exceeds the fair value of the asset, an impairment loss would be recognized in
earnings.  The  determination  of  fair  value  includes  numerous  uncertainties,  such  as  the  impact  of  competition  on  future  value.  We  believe  that  we  have  made
reasonable estimates and judgments in determining whether our long-term assets have been impaired; however, if there is a material change in the assumptions
used in our determination of fair value or if there is a material change in economic conditions or circumstances influencing fair value, we could be required to
recognize certain impairment charges in the future. As a result of our most recent reviews, no changes in asset values were required.

Income Taxes

Deferred income taxes are recognized for the tax consequences related to temporary differences between the carrying amount of assets and liabilities for financial
reporting purposes and the amounts used for tax purposes at each year-end, based on enacted tax laws and statutory tax rates applicable to the periods in which the
differences  are  expected  to  affect  taxable  income.  A  valuation  allowance  is  established  when  necessary  based  on  the  weight  of  available  evidence,  if  it  is
considered more likely than not that all or some portion of the deferred tax assets will not be realized. Income tax expense is the sum of current income tax plus the
change in deferred tax assets and liabilities.

We are subject  to income taxes in the United States and numerous state  and local jurisdictions.  The determination  of the income tax provision is an inherently
complex process, requiring management to interpret continually changing regulations and to make certain significant judgments. Our assumptions, judgments and
estimates relative to the amount of deferred income taxes take into account scheduled reversals of deferred tax liabilities, recent financial operations, estimates of
the amount of future taxable income and available tax planning strategies. Actual operating results in future years could render our current assumptions, judgments
and  estimates  inaccurate.  No  assurance  can  be  given  that  the  final  impact  of  these  matters  will  not  be  different  from  that  which  is  reflected  in  the  Company’s
historical income tax provisions and accruals. The Company adjusts these items in light of changing facts and circumstances. To the extent that the final impact of
these matters is different than the amounts recorded, such differences could have a material effect on the income tax provisions or benefits in the periods in which
such determinations are made.

Liquidity and Capital Resources

Cash generated through operations is our primary source of liquidity. At December 31, 2018, we had cash, cash equivalents and marketable securities of $102.4
million and working capital of $344.7 million, compared to December  31, 2017 cash, cash equivalents and marketable  securities of $82.8 million  and working
capital of $343.2 million. The change in working capital is driven by growth in our business and by the timing of cash receipts and cash payments. In addition, as
of December 31, 2018, we had an unused line of credit of $379.1 million. Our current ratio at December 31, 2018 was 3.1 to 1, versus 2.9 to 1 at December 31,
2017. Marketable securities represents fixed income investments which are highly liquid and can be readily purchased or sold through established markets and are
held by our captive insurance company that are required by state insurance regulations to remain in the captive insurance company. 

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For the years ended December 31, 2018, 2017 and 2016, our cash flows were as follows:

2018

Year Ended December 31, 

2017

(in thousands) 

2016

Net cash provided by operating activities 

Net cash used in investing activities 

Net cash used in financing activities 

$

$

$

80,031  $

(9,586) $

(53,977) $

7,630  $

(14,967) $

(6,959) $

41,400 

(6,452)

(44,284)

Operating Activities

Our primary sources of cash are the revenues generated from our Housekeeping and Dietary services. Our primary uses of cash are the funding of our payroll and
other personnel-related costs, as well as the costs of supplies used in providing our services. The timing of cash receipts and cash payments are the primary drivers
of the period-over-period changes in net cash provided by operating activities.

Investing Activities

The  principal  uses  of  cash  for  investing  activities  are  our  purchases  of  marketable  securities  and  capital  expenditures  such  as  those  for  housekeeping  and  food
service equipment, computer software and equipment, and furniture and fixtures (see “Capital Expenditures” below for additional information). Such uses of cash
are partially offset by proceeds from sales of marketable securities.

Our  investments  in  marketable  securities  are  primarily  comprised  of  tax-exempt  municipal  bonds  and  are  intended  to  achieve  our  goal  of  preserving  principal,
maintaining  adequate  liquidity  and  maximizing  returns  subject  to  our  investment  guidelines.  Our  investment  policy  limits  investment  to  certain  types  of
instruments issued by institutions primarily with investment-grade ratings and places restrictions on concentration by type and issuer.

Financing Activities

The  primary  use  of  cash  for  financing  activities  is  the  payment  of  dividends.  We  have  paid  regular  quarterly  cash  dividends  since  the  second  quarter  of  2003.
During 2018, we paid to shareholders regular quarterly cash dividends totaling $57.2 million, as follows:

March 31, 2018

June 30, 2018

September 30, 2018

December 31, 2018

(amounts in thousands, except per share data) 

Quarter Ended 

Cash dividend per common share

Total cash dividends paid

$

$

Record date

Payment date

0.19125  $

14,149  $

February 16, 2018

March 23, 2018

0.19250  $

14,249  $

May 25, 2018

June 29, 2018

0.19375  $

14,350  $

0.19500 

14,453 

August 24, 2018

November 23, 2018

September 28, 2018

December 28, 2018

Additionally,  on  February  5,  2019,  our  Board  of  Directors  declared  a  regular  quarterly  cash  dividend  of  $0.19625  per  common  share,  which  will  be  paid  on
March 22, 2019 to shareholders of record as of the close of business on February 15, 2019.

The  dividends  paid  to  shareholders  during  the  year  ended  December  31,  2018  were  funded  through  cash  generated  from  operations.  Our  Board  of  Directors
reviews our dividend policy on a quarterly basis and as part of such review considers our results of operations, financial condition and terms of our credit facility.
Although there can be no assurance that we will continue to pay dividends or the amount of the dividends, we expect to continue to pay a regular quarterly cash
dividend. Partially offsetting the cash used to pay dividends are the proceeds received from the exercise of stock options by employees and directors. In connection
with the establishment of our dividend policy, we adopted a Dividend Reinvestment Plan in 2003.

The  primary  source  of  cash  from  financing  activities  is  the  net  borrowings  under  our  bank  line  of  credit.  We  borrow  for  general  corporate  purposes  as  needed
throughout the year. The outstanding short-term borrowings balance as of December 31, 2018 relates to cash flow requirements due to the timing of cash receipts
and cash payments.

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We  did  not  repurchase  any  of  our  Common  Stock  during  2018,  but  we  remain  authorized  to  repurchase  1.7  million  shares  of  our  Common  Stock  pursuant  to
previous Board of Directors’ authorization.

Contractual Obligations

Our future contractual obligations and commitments at December 31, 2018 consist of the following:

Payments Due by Period 

Year Ended December 31, 2018

Total

Less Than 1 Year

1-3 Years

3-5 Years

After 5 Years

Operating lease obligations

$

9,130  $

3,203  $

3,896  $

1,354  $

677 

(in thousands) 

Line of Credit

As of December 31, 2018, we had a $475 million bank line of credit on which to draw for general corporate purposes. Amounts drawn under the line of credit are
payable upon demand and generally bear interest at a floating rate, based on our leverage ratio, and starting at LIBOR plus 115 basis points (or if LIBOR becomes
unavailable,  the  higher  of  the  Overnight  Bank  Funding  Rate,  plus  50  basis  points  and  the  Prime  Rate).  At  December  31,  2018,  there  were  $30.0  million  in
borrowings under the line of credit.

The line of credit requires us to satisfy two financial covenants. The covenants and respective status at December 31, 2018 were as follows:
Covenant Description and Requirement 

As of December 31, 2018

Funded debt 1 to EBITDA 2 ratio: less than 3.50 to 1.00

EBITDA 2 to Interest Expense ratio: not less than 3.0 to 1.00

0.59 

38.20 

1 

2 

All indebtedness for borrowed money including, but not limited to, capitalized lease obligations, reimbursement  obligations in respect of letters of credit and guarantees
of any such indebtedness.
Net income plus int erest expense, income tax expense, depreciation, amortization, stock compensation expense and extraordinary non-recurring losses/gains.

As shown in the table above, we were in compliance with our financial covenants at December 31, 2018 and we expect to continue to remain in compliance with
such financial covenants. The line of credit expires on December 21, 2023.

At December 31, 2018, we also had outstanding $65.9 million in irrevocable standby letters of credit, which relate to payment obligations under our insurance
programs.  In  connection  with  the  issuance  of  the  letters  of  credit,  the  amount  available  under  the  line  of  credit  was  further  reduced  by  $65.9  million  at
December 31, 2018. On January 2, 2019, we amended our letters of credit and decreased the outstanding amount to $62.7 million. The amended letters of credit
expire on January 2, 2020.

Accounts and Notes Receivable

Decisions to grant or to extend credit to customers are made on a case-by-case basis and based on a number of qualitative and quantitative factors related to the
particular client as well as the general risks associated with operating within the healthcare industry.

Fluctuations in net accounts and notes receivable are attributable to a variety of factors including, but not limited to, the timing of cash receipts from customers, the
Company’s  assessment  of  collectability  and  corresponding  provision  for  bad  debt  expense  and  the  inception,  transition,  modification  or  termination  of  client
relationships.

We  deploy  significant  resources  and  have  invested  in  tools  and  processes  to  optimize  our  credit  and  collections  efforts.  When  appropriate,  we  utilize  interest-
bearing promissory notes as an alternative to accounts receivable to further enhance the collectability of amounts due by memorializing the amount and related
payment schedule as well as securing additional business protections and guarantees.

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In order to provide for collections issues and the general risk associated with the granting of credit terms, we recorded a bad debt provision (in an Allowance for
Doubtful Accounts) of $51.4 million, $6.3 million and $4.6 million in the years ended December 31, 2018, 2017 and 2016, respectively. As a percentage of total
revenues, these provisions represented approximately 2.6% for the year ended December 31, 2018, and 0.3% for the years ended December 31, 2017 and 2016.

Insurance Programs

We  self-insure  or carry  a high deductible  insurance  plan  and therefore  we retain  a substantial  portion  of the risk associated  with the expected  losses under our
general  liability  and workers compensation  programs.  Under our insurance  plans for general  liability  and workers’ compensation,  predetermined  loss limits  are
arranged  with  our  insurance  company  to  limit  both  our  per  occurrence  cash  outlay  and  annual  insurance  plan  cost.  Our  accounting  for  this  plan  is  affected  by
various  uncertainties,  such  as  historical  claims,  pay-out  experience,  demographic  factors,  industry  trends,  severity  factors,  and  other  actuarial  assumptions
calculated by a third party actuary. Evaluations of our accrued insurance claims estimate as of the balance sheet date are based primarily on current information
derived from our actuarial valuation which assists in quantifying and valuing these trends. In the event that our claims experience and/or industry trends result in an
unfavorable change resulting from, among other factors, the severity levels of reported claims and medical cost inflation, as compared to historical claim trends, it
would  have  an  adverse  effect  on  our  results  of  operations  and  financial  condition.  Under  these  plans,  predetermined  loss  limits  are  arranged  with  an  insurance
company to limit both our per-occurrence cash outlay and annual insurance plan cost.

For general liability and workers’ compensation, we record a reserve for the estimated future cost of claims and related expenses that have been reported but not
settled, including an estimate of claims incurred but not reported that are developed as a result of a review of our historical data and open claims, which is based on
estimates provided by a third party actuary.

Capital Expenditures

Our level of capital expenditures is generally dependent on the number of new clients obtained. Such capital expenditures primarily consist of housekeeping and
food service equipment purchases, laundry and linen equipment installations, computer hardware and software, and furniture and fixtures. Our capital expenditures
totaled $4.9 million in 2018. Although we have no specific material commitments for capital expenditures through the end of calendar year 2019, we estimate that
for that period we will have capital expenditures of approximately $5.0 million to $7.0 million. We believe that our cash from operations, existing cash and cash
equivalents balance and credit line will be adequate for the foreseeable future to satisfy the needs of our operations and to fund our anticipated growth. However,
should these sources not be sufficient, we would seek to obtain necessary capital from such sources as long-term debt or equity financing.

Material Off-Balance Sheet Arrangements

We have no material off-balance sheet arrangements, other than our irrevocable standby letter of credit.

Effects of Inflation

Although  there  can  be  no  assurance  thereof,  we  believe  that  in  most  instances  we  will  be  able  to  recover  increases  in  costs  attributable  to  inflation  by  passing
through such cost increases to our clients.

Item 7A.     Quantitative and Qualitative   Disclosures About Market Risk.

At December 31, 2018, we had investments in municipal bonds of $76.4 million. Our municipal bonds are categorized as marketable securities and are subject to
interest rate risk, as changes in interest rates affect the fair values of those instruments. Investments in both fixed rate and floating rate investments carry a degree
of interest rate risk. The value of fixed rate securities may be adversely impacted due to an increase in interest rates, while floating rate securities may produce less
income than expected if interest rates fall. Due in part to these factors, our future investment income may fall short of expectations due to changes in interest rates
or  if  there  is  a  decline  in  the  fair  value  of  our  investments.  We  make  investments  in  instruments  that  meet  our  credit  quality  standards,  as  specified  in  our
investment policy guidelines.

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Item 8.     Financial Statements and Supplementary   Data.

INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm 

Management's Report on Internal Control Over Financial Reporting 

Report of Independent Registered Public Accounting Firm 

Consolidated Financial Statements 

Consolidated Balance Sheets as of December 31, 2018 and 2017 

Consolidated Statements of Comprehensive Income for the Years Ended December 31, 2018, 2017 and 2016 

Consolidated Statements of Cash Flows for the Years Ended December 31, 2018, 2017 and 2016 

Consolidated Statements of Stockholders' Equity for the Years Ended December 31, 2018, 2017 and 2016 

Notes to Consolidated Financial Statements for the Years Ended December 31, 2018, 2017 and 2016 

31

Page

32

33

34

35

36

37

38

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

Board of Directors and Stockholders
Healthcare Services Group, Inc.

Opinion on the financial statements

We have audited the accompanying consolidated balance sheets of Healthcare Services Group, Inc. (a Pennsylvania corporation) and subsidiaries (the “Company”)
as of December 31, 2018 and 2017, the related consolidated statements of comprehensive income, stockholders’ equity, and cash flows for each of the three years
in the period ended December 31, 2018, and the related notes and financial statement schedules included under Item 15(a) (collectively referred to as the “financial
statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2018 and
2017,  and  the  results  of  its  operations  and  its  cash  flows  for  each  of  the  three  years  in  the  period  ended  December  31,  2018,  in  conformity  with  accounting
principles  generally  accepted  in  the  United  States  of  America.  We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting
Oversight Board (United States) (“PCAOB”), the Company’s internal control over financial reporting as of December 31, 2018, based on criteria established in the
2013  Internal  Control—Integrated  Framework  issued  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission  (“COSO”),  and  our  report
dated March 18, 2019 expressed an unqualified opinion.

Basis for opinion  

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements
based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance
with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable
assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. Our audits included performing procedures to
assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such
procedures included examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. Our audits also included evaluating
the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We
believe that our audits provide a reasonable basis for our opinion.

/s/ GRANT THORNTON LLP

We have served as the Company’s auditor since 1992.

New York, New York

March 18, 2019

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Management’s Annual Report on Internal Control Over Financial   Reporting

The management of Healthcare Services Group, Inc. (“Healthcare”, “We” or the “Company”), is responsible for establishing and maintaining adequate internal
control  over  financial  reporting.  The  Company’s  internal  control  over  financial  reporting  is  defined  in  Rule  13a-15(f)  and  15d-15(f)  promulgated  under  the
Securities  Exchange  Act  of  1934 as a  process  designed  by, or  under  the  supervision  of,  the  Company’s  principal  executive  and  principal  financial  officers  and
effected by the Company’s board of directors, management and other personnel, to provide reasonable assurance regarding the reliability of financial reporting and
the preparation of the Company’s financial statements for external purposes in accordance with generally accepted accounting principles in the United States and
includes those policies and procedures that:

1 

2 

3 

Pertain to the maintenance of records that in reasonable detail accurately and fairly reflect the transactions and dispositions of assets of the Company;

Provide  reasonable  assurance  that  transactions  are  recorded  as  necessary  to  permit  preparation  of  financial  statements  in  accordance  with  generally
accepted accounting principles, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management
and directors of the Company; and

Provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the Company’s assets that could
have a material effect on the financial statements.

The  Company’s  management  assessed  the  effectiveness  of  the  Company’s  internal  control  over  financial  reporting  as  of  December  31,  2018.  In  making  this
assessment,  the  Company’s  management  used  the  criteria  set  forth  in  Internal  Control  -Integrated  Framework  issued  by  the  Committee  of  Sponsoring
Organizations of the Treadway Commission (the “2013 Framework”).

Under the supervision  and  with the  participation  of our management,  including  our principal  executive  officer  and principal  financial  officer,  we conducted  an
evaluation  of  our  internal  control  over  financial  reporting,  as  prescribed  above,  for  the  period  covered  by  this  report.  Based  on  our  evaluation,  our  principal
executive officer and principal financial officer concluded that the Company’s internal control over financial reporting as of December 31, 2018 is effective as a
whole.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Projections of any evaluation of effectiveness
to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or
procedures may deteriorate.

The  Company’s  independent  registered  public  accounting  firm  has  audited,  and  reported  on,  the  Company’s  internal  control  over  financial  reporting  as  of
December 31, 2018.

/s/ Theodore Wahl

Theodore Wahl
Chief Executive Officer
(Principal Executive Officer)
March 18, 2019

/s/ John C. Shea

John C. Shea
Chief Financial Officer
(Principal Financial and Accounting Officer)
March 18, 2019

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

Board of Directors and Stockholders
Healthcare Services Group, Inc.

Opinion on internal control over financial reporting

We have audited the internal control over financial reporting of Healthcare Services Group, Inc. (a Pennsylvania corporation) and subsidiaries (the “Company”) as
of December 31, 2018, based on criteria established in the 2013 Internal
Control-Integrated
Framework
issued by the Committee of Sponsoring Organizations of
the Treadway Commission (“COSO”). In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of
December 31, 2018, based on criteria established in the 2013 Internal
Control-Integrated
Framework
issued by COSO.

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States)  (“PCAOB”),  the  consolidated
financial statements of the Company as of and for the year ended December 31, 2018, and our report dated March 18, 2019 expressed an unqualified opinion on
those financial statements.

Basis for opinion

The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal
control over financial reporting, included in the accompanying Management’s Annual Report on Internal Control Over Financial Reporting. Our responsibility is to
express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and
are  required  to  be  independent  with  respect  to  the  Company  in  accordance  with  the  U.S.  federal  securities  laws  and  the  applicable  rules  and  regulations  of  the
Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance
about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal
control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of internal control
based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable
basis for our opinion.

Definition and limitations of internal control over financial reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the
preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial
reporting  includes  those  policies  and  procedures  that  (1)  pertain  to  the  maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the
transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of
financial  statements  in  accordance  with  generally  accepted  accounting  principles,  and  that  receipts  and  expenditures  of  the  company  are  being  made  only  in
accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of
unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.

Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements.  Also,  projections  of  any  evaluation  of
effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with
the policies or procedures may deteriorate.

/s/ GRANT THORNTON LLP

New York, New York

March 18, 2019

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ASSETS:

Current assets:

Cash and cash equivalents

Marketable securities, at fair value

Healthcare Services Group, Inc.
Consolidated Balance Sheets
(in thousands, except per share amounts)

As of December 31,

2018

2017

Accounts and notes receivable, less allowance for doubtful accounts of $47,209 and $11,985 as of December 31,
2018 and 2017, respectively 

Inventories and supplies

Prepaid expenses and other assets

Total current assets

Property and equipment, net

Goodwill

Other intangible assets, less accumulated amortization of $17,216 and $12,853 as of December 31, 2018 and 2017,
respectively

Notes receivable – long–term portion, less allowance for doubtful accounts of $10,000 and $0 as of December 31,
2018 and 2017, respectively 

Deferred compensation funding, at fair value

Deferred income taxes

Other noncurrent assets

Total assets

LIABILITIES AND STOCKHOLDERS’ EQUITY:

Current liabilities:

Accounts payable

Accrued payroll, accrued and withheld payroll taxes

Other accrued expenses

Borrowings under line of credit

Income taxes payable

Accrued insurance claims

Total current liabilities

Accrued insurance claims — long-term portion

Deferred compensation liability

Commitments and contingencies

STOCKHOLDERS’ EQUITY:

Common Stock, $.01 par value; 100,000 shares authorized; 75,344 and 74,960 shares issued, and 73,877 and
73,436 shares outstanding as of December 31, 2018 and 2017, respectively 

Additional paid-in capital

Retained earnings

Accumulated other comprehensive income, net of taxes

Common Stock in treasury, at cost, 1,467 shares and 1,524 shares as of December 31, 2018 and 2017, respectively 

Total stockholders’ equity

Total liabilities and stockholders’ equity

See accompanying notes.

35

$

$

$

26,025  $

76,362 

341,838 

41,443 

22,468 

508,136 

12,900 

51,084 

26,518 

43,043 

29,113 

20,552 

1,257 

692,603  $

61,467  $

35,198 

8,890 

30,000 

7,140 

20,696 

163,391 

58,904 

29,528 

753 

259,440 

190,092 

158 

(9,663)

440,780 

$

692,603  $

9,557 

73,221 

378,720 

42,393 

23,515 

527,406 

13,509 

51,084 

30,881 

15,476 

28,885 

7,498 

1,264 

676,003 

74,463 

32,139 

4,561 

35,382 

15,378 

22,245 

184,168 

62,454 

29,429 

750 

244,363 

163,860 

837 

(9,858)

399,952 

676,003 

 
 
Table of Contents

Revenues

Operating costs and expenses:

Costs of services provided

Selling, general and administrative

Other (expense) income:

Investment and interest

Income before income taxes

Income taxes

Net income

Per share data: 

Basic earnings per common share

Diluted earnings per common share

Healthcare Services Group, Inc.
Consolidated Statements of Comprehensive Income
(in thousands, except per share amounts)

Years Ended December 31,

2018

2017

2016

$

2,008,821  $

1,866,131  $

1,562,662 

1,771,981 

136,603 

(327)

99,910 

16,386 

1,612,510 

126,732 

6,076 

132,965 

44,739 

83,524  $

88,226  $

1.13  $

1.12  $

1.20  $

1.19  $

74,002 

74,612 

73,355 

74,348 

1,339,492 

105,417 

2,634 

120,387 

42,991 

77,396 

1.06 

1.05 

72,754 

73,474 

83,524  $

88,226  $

77,396 

(679)

82,845  $

1,156 

89,382  $

(862)

76,534 

$

$

$

$

$

Weighted average number of common shares outstanding: 

Basic

Diluted

Comprehensive income: 

Net income

Other comprehensive income:

Unrealized (loss) gain on available-for-sale marketable securities, net of taxes

Total comprehensive income

See accompanying notes.

36

 
 
 
Table of Contents

Healthcare Services Group, Inc.
Consolidated Statements of Cash Flows
(in thousands)

Cash flows from operating activities:

Net income

Adjustments to reconcile net income to net cash provided by operating activities:

Depreciation and amortization

Bad debt provision

Deferred income tax (benefit) expense

Stock-based compensation expense 1

Tax benefit from equity compensation plans 1

Amortization of premium on marketable securities

Unrealized loss (gain) on deferred compensation fund investments 

Changes in operating assets and liabilities:

Accounts and notes receivable

Inventories and supplies

Prepaid expenses and other assets

Deferred compensation funding

Accounts payable and other accrued expenses

Accrued payroll, accrued and withheld payroll taxes

Accrued insurance claims

Deferred compensation liability

Income taxes payable 1

Net cash provided by operating activities

Cash flows from investing activities:

Disposals of fixed assets

Additions to property and equipment

Purchases of marketable securities

Sales of marketable securities

Cash paid for acquisitions

Net cash used in investing activities

Cash flows from financing activities:

Dividends paid

Reissuance of treasury stock pursuant to Dividend Reinvestment Plan

Tax benefit from equity compensation plans 1

Proceeds from the exercise of stock options

Net (repayments) proceeds from short-term borrowings

Net cash used in financing activities

Net change in cash and cash equivalents

Cash and cash equivalents at beginning of the period

Cash and cash equivalents at end of the period

Supplementary cash flow information:

Cash paid for interest

Cash paid for income taxes, net of refunds

Contingent shares settled pursuant to acquisition

Years Ended December 31,

2018

2017

2016

$

83,524  $

88,226  $

77,396 

9,272 

51,387 

(13,013)

5,900 

— 

1,373 

1,429 

8,886 

6,250 

1,887 

5,985 

— 

1,296 

(4,509)

7,496 

4,629 

3,001 

4,252 

(2,981)

1,723 

(1,460)

(44,363)

(121,639)

(65,610)

950 

1,054 

(1,536)

(9,144)

6,085 

(5,099)

450 

(8,238)

80,031 

640 

(4,940)

(14,297)

9,011 

— 

(9,586)

(1,873)

(9,545)

(257)

11,197 

11,927 

(2,954)

5,061 

7,692 

7,630 

338 

(5,397)

(33,861)

28,537 

(4,584)

(14,967)

(1,492)

(2,470)

2,732 

(4,251)

6,307 

5,404 

(731)

7,455 

41,400 

275 

(5,442)

(29,449)

28,164 

— 

(6,452)

(57,201)

(55,244)

(53,342)

89 

— 

8,517 

(5,382)

(53,977)

16,468 

9,557 

95 

— 

12,808 

35,382 

(6,959)

(14,296)

23,853 

$

$

$

$

26,025  $

9,557  $

3,094  $

37,680  $

2,291  $

1,363  $

35,367  $

—  $

109 

2,981 

5,968 

— 

(44,284)

(9,336)

33,189 

23,853 

574 

32,532 

— 

1 

  The Company adopted the provisions of ASU 2016-09 prospectively, and as such the amounts reflected for the year ended December 31, 2016 have not been adjusted.

See accompanying notes.

37

 
 
Exercise of stock options and other stock-based compensation, net of
shares tendered for payment 

301 

3 

Table of Contents

Balance, December 31, 2015 

Comprehensive income: 

Net income for the period 

Unrealized loss on available-for-sale marketable securities, net of
taxes 

Comprehensive income for the period 

Tax benefit from equity compensation plans 

Share-based compensation expense — stock options and restricted
stock 

Treasury shares issued for Deferred Compensation Plan funding and
redemptions 

Shares issued pursuant to Employee Stock Plan 

Dividends paid 

Shares issued pursuant to Dividend Reinvestment Plan 

Shares issued pursuant to previous settlement 

Other  

Balance, December 31, 2016 

Comprehensive income: 

Net income for the period 

Unrealized gain on available-for-sale marketable securities, net of
taxes 

Comprehensive income for the period 

Exercise of stock options and other stock-based compensation, net of
shares tendered for payment 

Share-based compensation expense — stock options, restricted stock
and restricted stock units 

Treasury shares issued for Deferred Compensation Plan funding and
redemptions 

Shares issued pursuant to Employee Stock Plan 

Dividends paid and accrued 

Shares issued pursuant to Dividend Reinvestment Plan 

Shares issued pursuant to acquisition 

Balance, December 31, 2017 

Comprehensive income: 

Net income for the period 

Unrealized loss on available-for-sale marketable securities, net of
taxes 

Comprehensive income for the period 

Exercise of stock options and other stock-based compensation, net of
shares tendered for payment 

Share-based compensation expense — stock options, restricted stock
and restricted stock units 

Treasury shares issued for Deferred Compensation Plan funding and
redemptions 

Shares issued pursuant to Employee Stock Plan 

Dividends paid and accrued 

Shares issued pursuant to Dividend Reinvestment Plan 

Contingent shares settled pursuant to acquisition 

Other  

Balance, December 31, 2018 

Healthcare Services Group, Inc.
Consolidated Statements of Stockholders’ Equity
(in thousands)

Common Stock 

Shares 

Amount 

Additional Paid-in
Capital 

Accumulated Other
Comprehensive Income
(Loss), net of Taxes 

Retained Earnings 

Treasury Stock 

Stockholders’
Equity 

73,793  $

738  $

199,294 

$

543  $

106,886  $

(11,005)

$

296,456 

77,396 

(862)

(53,342)

431 

371 

18 

5,965 

2,773 

3,743 

103 

1,696 

91 

3,999 

217,664 

(319)

130,940 

(10,185)

88,226 

1,156 

113 

(3)

74,204 

1 

742 

697 

7 

12,801 

4,945 

181 

1,752 

82 

6,938 

244,363 

8,514 

5,580 

519 

2,475 

75 

(2,291)

205 

59 

74,960 

1 

750 

380 

3 

4 

(55,306)

(25)

339 

13 

837 

163,860 

(9,858)

83,524 

(679)

(165)

346 

14 

(57,361)

69 

75,344  $

753  $

259,440 

$

158  $

190,092  $

(9,663)

$

See accompanying notes.

38

$

$

$

77,396 

(862)

76,534 

5,968 

2,773 

3,743 

534 

2,067 

(53,342)

109 

4,000 

— 

338,842 

88,226 

1,156 

89,382 

12,808 

4,945 

156 

2,091 

(55,306)

95 

6,939 

399,952 

83,524 

(679)

82,845 

8,517 

5,580 

354 

2,821 

(57,361)

89 

(2,291)

274 

440,780 

 
 
Table of Contents

Healthcare Services Group, Inc.
Notes to Consolidated Financial Statements
Years Ended December 31, 2018, 2017 and 2016 

Note 1— Description of Business and Significant Accounting Policies

Nature of Operations

Healthcare Services Group, Inc. (the “Company”) provides management, administrative and operating expertise and services to the housekeeping, laundry, linen,
facility maintenance and dietary service departments of the healthcare industry, including nursing homes, retirement complexes, rehabilitation centers and hospitals
located  throughout  the  United  States.  Although  the  Company  does  not  directly  participate  in  any  government  reimbursement  programs,  the  Company’s  clients
receive government reimbursements related to Medicare and Medicaid. Therefore, they are directly affected by any legislation relating to Medicare and Medicaid
reimbursement programs.

The Company provides services primarily pursuant to full service agreements with its clients. In such agreements, the Company is responsible for the day-to-day
management of employees located at the clients’ facilities. The Company also provides services on the basis of management-only agreements for a limited number
of clients. The agreements with clients typically provide for a renewable one year service term, cancelable by either party upon 30 to 90 days’ notice after an initial
period of 60 to 120 days.

The  Company  is  organized  into  two  reportable  segments;  housekeeping,  laundry,  linen  and  other  services  (“Housekeeping”),  and  dietary  department  services
(“Dietary”).

Housekeeping  consists  of  managing  the  clients’  housekeeping  departments,  which  are  principally  responsible  for  the  cleaning,  disinfecting  and  sanitizing  of
resident rooms and common areas of a client’s facility, as well as the laundering and processing of the bed linens, uniforms, resident personal clothing and other
assorted linen items utilized at a client facility.

Dietary consists of managing the clients’ dietary departments, which are principally responsible for food purchasing, meal preparation and dietitian professional
services, which includes the development of menus that meet residents’ dietary needs.

Use of Estimates in Financial Statements

In preparing  financial statements in conformity  with U.S. GAAP, estimates  and assumptions are made that affect the reported amounts of assets and liabilities,
disclosures of contingent assets and liabilities, and the reported amounts of revenues and expenses. Actual results could differ from those estimates. Significant
estimates are used in determining, but are not limited to, the Company’s allowance for doubtful accounts, accrued insurance claims, valuations, deferred taxes and
reviews  for  potential  impairment.  The  estimates  are  based  upon  various  factors  including  current  and  historical  trends,  as  well  as  other  pertinent  industry  and
regulatory authority information. Management regularly evaluates this information to determine if it is necessary to update the basis for its estimates and to adjust
for known changes. 

Principles of Consolidation

The accompanying consolidated financial statements  include the accounts of Healthcare Services Group, Inc. and its wholly-owned subsidiaries. All significant
intercompany transactions and balances have been eliminated in consolidation. 

Fair Value of Financial Instruments

The  Company  determines  fair  value  as  the  price  that  would  be  received  to  sell  an  asset  or  paid  to  transfer  a  liability  in  an  orderly  transaction  between  market
participants at the measurement date. The Company utilizes valuation techniques that maximize the use of observable inputs (Levels 1 and 2) and minimize the use
of unobservable inputs (Level 3) within the fair value hierarchy.

Assets and liabilities are classified within the fair value hierarchy based on the lowest level (least observable) input that is significant to the measurement in its
entirety.

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Table of Contents

While unobservable inputs reflect the Company's market assumptions. Preference is given to observable inputs. These two types of inputs create the following fair
value hierarchy:

Level 1 – Quoted prices for identical instruments in active markets;
Level 2 – Quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and
model-derived valuations whose inputs are observable or whose significant value drivers are observable; and
Level 3 – Significant inputs to the valuation model are unobservable

The  Company’s  financial  instruments  that  are  measured  at  fair  value  on  a  recurring  basis  consist  of  marketable  securities  and  the  deferred  compensation  fund
investments. Other financial instruments such as cash and cash equivalents, accounts and notes receivable, accounts payable (including income taxes payable and
accrued expenses) and borrowings under the Company’s line of credit are short-term in nature, and therefore the carrying value of these instruments are deemed to
approximate their fair value.

The Company has certain notes receivable that either do not bear interest or bear interest at a below-market rate. Therefore, such notes receivable of $2.9 million
and $6.9 million at December 31, 2018 and 2017, respectively,  have been discounted to their present value and are reported at values of $2.9 million and $6.8
million at December 31, 2018 and 2017, respectively. See Note 6—Fair Value Measurements for the fair value hierarchy table and for details on the measurement
of fair value for assets and liabilities.

Cash and Cash Equivalents

Cash and cash equivalents are held in U.S. financial institutions or in custodial accounts with U.S. financial institutions. Cash equivalents are defined as short-term,
highly liquid investments with a maturity of three months or less at time of purchase that are readily convertible into cash and have insignificant interest rate risk.

Investments in Marketable Securities

Marketable  securities  are  defined  as  fixed  income  investments  which  are  highly  liquid  and  can  be  readily  purchased  or  sold  through  established  markets.  As
of December 31, 2018 and 2017, the Company had marketable securities of $76.4 million and $73.2 million, respectively, which were comprised primarily of tax-
exempt  municipal  bonds. These  investments are  accounted for  as  available-for-sale securities and  are  reported  at  fair  value  on  the  balance  sheet. For the  years
ended December 31, 2018 and 2017, $0.8 million of unrealized losses and $1.1 million of unrealized gains related to these investments were recorded in other
comprehensive income, respectively. Unrealized gains and losses are recorded net of income taxes.

These  assets  are  available  for  future  needs  under  the  Company’s  self-insurance  programs  and  are  held  by  the  Company's  wholly-owned  captive  subsidiary  as
required  by  state  insurance  regulations.  The  Company’s  investment  policy  is  intended  to  manage  the  assets  to  achieve  the  goals  of  preserving  principal,
maintaining adequate liquidity at all times, and maximizing returns subject to investment guidelines. The investment policy limits investment to certain types of
instruments issued by institutions primarily with investment grade credit ratings and places restrictions on concentration by type and issuer.

The  Company  periodically  reviews  the  investments  in  marketable  securities  for  other  than  temporary  declines  in  fair  value  below  the  cost  basis  and  whenever
events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. As of December 31, 2018, management believes that the
recorded value of the Company’s investments in marketable securities was recoverable in all material respects. See Note 6—Fair Value Measurements for other
than temporary impairment considerations.

Inventories and Supplies

Inventories and supplies include housekeeping, linen and laundry supplies, as well as food provisions and supplies. Non-linen inventories and supplies are stated at
cost to approximate a first-in, first-out (FIFO) basis. Linen supplies are amortized on a straight-line basis over their estimated useful life of 24 months.

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Table of Contents

Property and Equipment

Property and equipment are stated at cost, net of accumulated depreciation. Additions, renewals and improvements are capitalized, while maintenance and repair
costs are expensed when incurred. When assets are retired or otherwise disposed of, the cost and related accumulated depreciation are removed from the respective
accounts and any resulting gain or loss is included in income. Depreciation is recorded using the straight-line method over the following estimated useful lives:
Housekeeping and Dietary equipment — 5 to 7 years; computer hardware and software — 3 to 7 years; and other, consisting of furniture and fixtures, leasehold
improvements and vehicles — 5 to 10 years. Depreciation expense on property and equipment for the years ended December 31, 2018, 2017 and 2016 was $4.9
million, $5.0 million and $4.8 million, respectively.

Revenue Recognition

The Company recognizes revenue from service agreements with customers when or as the promised goods and services are provided to customers. Revenues are
reported net of sales taxes that are collected from customers and remitted to taxing authorities.

The  guidance  under  the  Financial  Accounting  Standards  Board  (“FASB”)  Accounting  Standards  Codification  subtopic  606  Revenue  from  Contracts  with
Customers (“ASC 606”) became effective and was adopted by the Company as of January 1, 2018, by applying the modified retrospective method for contracts
that were not completed as of January 1, 2018. The standard requires the Company to recognize revenue as the promised goods and services within the terms of the
Company’s  contracts  are  performed  and  satisfied.  The  amount  of  revenue  which  the  Company  recognizes  is  based  on  the  consideration  which  the  Company
expects to be entitled to in exchange for contracted promised goods and services. The adoption of this standard did not have a material impact to the Company's
accounting for revenue earned relating to the Housekeeping and Dietary segments. The Company also did not recognize an opening adjustment to retained earnings
as a result of the adoption of the standard. See Note 2—Revenue herein for additional revenue disclosure that is being presented as a result of the newly adopted
standard.

Prior period amounts were not adjusted and continue to be reported in accordance with previous guidance.

Income Taxes

The Company uses the asset and liability method of accounting for income taxes. Under this method, income tax expense is recognized for the amount of taxes
payable  or  refundable  for  the  current  period.  The  Company  accrues  for  probable  tax  obligations  as  required  by  facts  and  circumstances  in  various  regulatory
environments. In addition, deferred tax assets and liabilities are recognized for expected future tax consequences of temporary differences between the financial
reporting and tax basis of assets and liabilities. When appropriate, valuation allowances are recorded to reduce deferred tax assets to amounts for which realization
is more likely than not. Deferred tax assets and liabilities are more fully described in Note 13— Income Taxes.

Uncertain income tax positions taken or expected to be taken in tax returns are reflected within the Company’s financial statements based on a recognition and
measurement process. 

The Company may from time to time be assessed interest or penalties by taxing jurisdictions, although any such assessments historically have been minimal and
immaterial to its financial results. When the Company has received an assessment for interest and/or penalties, it will be classified in the financial statements as
selling, general and administrative expense. In addition, any interest or penalties relating to recognized uncertain tax positions would also be recorded in selling,
general and administrative expense.

Earnings per Common Share

Basic  earnings  per  common  share  is  computed  by  dividing  income  available  to  common  shareholders  by  the  weighted-average  number  of  common  shares
outstanding  for  the  period.  Diluted  earnings  per  common  share  is  calculated  using  the  weighted-average  number  of  common  shares  outstanding  and  dilutive
common shares, such as those issuable upon exercise of stock options and upon the vesting of restricted stock and restricted stock units.

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Table of Contents

Share-Based Compensation

The Company estimates the fair value of share-based awards on the date of grant using the Black-Scholes valuation model for stock options and using the share
price on the date of grant for restricted stock and restricted stock units. The value of the award is recognized ratably as an expense in the Company’s Consolidated
Statements of Comprehensive Income over the requisite service periods, with adjustments made for forfeitures as they occur.

Advertising Costs

Advertising costs are expensed when incurred. Advertising costs were not material for the years ended December 31, 2018, 2017 and 2016.

Impairment of Long-Lived Assets

The  carrying  amounts  of long-lived  assets  are  periodically  reviewed  to  determine  whether  current  events  or  circumstances  warrant  adjustment  to such  carrying
amounts.  Any  impairment  would  be  measured  as  the  amount  that  the  carrying  value  of  such  assets  exceeds  their  fair  value,  primarily  based  on  estimated
undiscounted cash flows. Considerable management judgment is necessary to estimate the fair value of assets. Assets to be disposed of are carried at the lower of
their financial statement carrying amount or fair value, less cost to sell.

Identifiable Intangible Assets and Goodwill

Identifiable  intangible  assets  are  amortized  on  a  straight-line  basis  over  their  respective  lives.  Goodwill  represents  the  excess  of  cost  over  the  fair  value  of  net
assets of acquired businesses. Management reviews the carrying value of goodwill at least annually during the fourth quarter of each year to assess for impairment,
or more often if events or circumstances indicate that the carrying value may exceed its estimated fair value. No impairment loss was recognized on the Company’s
intangible assets or goodwill for the years ended December 31, 2018, 2017 or 2016.

In 2018, the Company adopted the FASB issued Accounting Standards Update 2017-04, Simplifying the Test for Goodwill Impairment (“ASU 2017-04”). ASU
2017-04 no longer requires the Company to perform a hypothetical purchase price allocation to measure impairment, eliminating step 2 of the goodwill impairment
test. Instead, impairment is measured using the difference of the carrying amount to the fair value of goodwill on a reporting unit basis.

Additionally in 2018, the Company adopted the FASB issued Accounting Standards Update 2018-15, Intangibles - Goodwill and Other - Internal-Use Software
("ASU 2018-15). ASU 2018-15 aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the
requirements  for  capitalizing  implementation  costs  incurred  to  develop  or  obtain  internal-use  software  (and  hosting  arrangements  that  include  an  internal-use
software license). The results of applying ASU 2018-15 were insignificant and did not have a material impact on the Company's consolidated financial statements.
The  capitalized  implementation  costs  incurred  from  adopting  ASU  2018-15  are  recorded  in  the  prepaid  expenses  and  other  assets  caption  in  the  Consolidated
Balance Sheets.

Treasury Stock

Treasury stock purchases are accounted for under the cost method whereby the entire cost of the acquired stock is recorded as treasury stock. Gains or losses on the
subsequent reissuance of shares are credited or charged to additional paid-in capital.

Reclassification

Certain prior period amounts have been reclassified to conform to current year presentation, including the presentation of tax benefit from equity compensation
plans in the Consolidated Statements of Cash Flows. The tax benefit from equity compensation plans is now reflected as a component of the change in income
taxes payable, as opposed to an offset to stock-based compensation expense. There was no impact to the Company's net cash provided by operating activities as a
result of the immaterial correction.

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Table of Contents

Concentrations of Credit Risk

The financial instruments that are subject to concentrations of credit risk are cash and cash equivalents, marketable securities, deferred compensation funding and
accounts and notes receivable. The Company’s marketable securities are fixed income investments which are highly liquid and can be readily purchased or sold
through established markets. At December 31, 2018 and 2017, substantially all of the Company’s cash and cash equivalents and marketable securities were held in
one large financial institution located in the United States.

The Company’s clients are concentrated in the healthcare industry and are primarily providers of long-term care. The revenues of many of the Company’s clients
are highly reliant on Medicare, Medicaid and third party payors’ reimbursement funding rates. New legislation or changes in existing regulations could directly
impact the governmental reimbursement programs in which the clients participate. As a result, the Company may not know the full effects of such programs until
these laws are fully implemented and governmental agencies issue applicable regulations or guidance.

Significant Clients

For  the  years  ended  December  31,  2018  and  2017,  the  Company  had  several  clients  who  individually  contributed  over  3%  of  the  Company's  consolidated
revenues, including Genesis Healthcare, Inc. ("Genesis") which accounted for $386.7 million or 19.3% and $327.5 million or 17.5%, respectively. Although the
Company expects to continue its relationships with these clients, there can be no assurance thereof. The loss, individually or in the aggregate, of such clients, or a
significant  reduction  in  the  revenues  the  Company  receives  from  such  clients,  could  have  a  material  adverse  effect  on  the  Company’s  results  of  operations.  In
addition, if any of these clients change or alter current payments terms, it could increase the Company’s accounts receivables balance and have a material adverse
effect on the Company’s cash flows.

Recent Accounting Pronouncements

In February 2016, the FASB issued ASU 2016-02,  Leases

("ASC 842"). ASC 842 requires lessees to recognize assets and liabilities on their balance sheet related
to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require
disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. The guidance is
effective  for  annual  reporting  periods  beginning  after  December  15,  2018,  and  interim  periods  within  those  years.  This  guidance  may  be  applied  through  a
modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial
statements with  certain  practical  expedients available. Alternatively, this  guidance may  also  be  applied  at  the  adoption date  by  recognizing a  cumulative-effect
adjustment to the opening balance of retained earnings in the period of adoption.

ASC 842 provides several optional practical expedients in transition including the ‘package of practical expedients,’ which permits the Company to not reassess
under the new standard the Company's prior conclusions about lease identification, lease classification and initial direct costs. ASC 842 also provides the Company
the option to, as an accounting policy, not capitalize lease obligations for leases with lease terms of less than 12 months.

The Company adopted ASC 842 as of January 1, 2019 using a modified retrospective transition approach which resulted in the capitalization of the Company's
existing operating leases as of January 1, 2019 which consisted of office space, vehicles and equipment. The Company elected to adopt ASC 842 using the package
of practical expedients mentioned above and elected to not capitalize leases with lease terms of less than 12 months. The lease liability and corresponding right-of-
use  asset  recognized  upon  adoption  of  ASU  842  was  $11.4  million.  The  Company  does  not  expect  ASC  842  to  have  a  material  impact  to  the  Consolidated
Statements  of  Operations  however  will  require  additional  disclosures  pertaining  to  the  Company's  lease  commitments.  The  Company  did  not  recognize  a
cumulative-effect adjustment to the opening balance of retained earnings. 

In June 2016, the FASB issued ASU No. 2016-13, Credit Losses - Measurement of Credit Losses on Financial Instruments ("ASC 326"). The standard significantly
changes how entities will measure credit losses for most financial assets and certain other instruments that are not measured at fair value through net income. The
standard  will  replace  today’s  “incurred  loss”  approach  with  an  “expected  loss”  model  for  instruments  measured  at  amortized  cost.  For  available-for-sale  debt
securities,  entities  will  be  required  to  record  allowances  rather  than  reduce  the  carrying  amount,  as  they  do  today  under  the  other-than-temporary  impairment
model. Entities will apply the standard’s provisions as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which
the  guidance  is  effective.  The  standard  is  effective  for  interim  and  annual  reporting  periods  beginning  after  December  15,  2019.  The  Company  is  currently
assessing the impact of adopting this standard on the Company’s financial statements and related disclosures.

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Note 2—Revenue

The  Company  disaggregates  its  consolidated  revenues  by  reportable  segment,  as  management  evaluates  the  nature,  amount,  timing  and  uncertainty  of  the
Company’s revenues by segment. Refer to Note 15—Segment Information herein as well as the information below regarding the Company’s reportable segments.

Housekeeping

Housekeeping  accounted  for  $973.8  million,  $979.6  million  and  $957.1  million,  of  the  Company’s  consolidated  revenues  for  the  years  ended  December  31,
2018,  2017  and  2016,  respectively.  The  services  provided  under  this  segment  include  managing  clients’  housekeeping  departments,  which  are  principally
responsible for the cleaning, disinfecting and sanitizing of resident rooms and common areas of the clients’ facilities, as well as the laundering and processing of
the bed linens, uniforms, resident personal clothing and other assorted linen items utilized at the clients’ facilities. Upon beginning service with a client facility, the
Company  will  typically  hire  and  train  the  employees  previously  employed  by  such  facility  and  assign  an  on-site  manager  to  supervise  and  train  the  front-line
personnel and coordinate housekeeping services with other facility support functions in accordance with client requests. Such management personnel also oversee
the execution of various cost and quality-control procedures including continuous training and employee evaluation, and on-site testing for infection control.

Dietary

Dietary services represented $1,035.0 million, $886.5 million and $605.5 million, of the Company’s consolidated revenues for the years ended December 31, 2018,
2017  and  2016,  respectively.  Dietary  services  consist  of  managing  clients’  dietary  departments  which  are  principally  responsible  for  food  purchasing,  meal
preparation  and  professional  dietitian  services,  which  include  the  development  of  menus  that  meet  the  dietary  needs  of  residents.  On-site  management  is
responsible  for  all  daily  dietary  department  activities,  with  regular  support  provided  by  a  District  Manager  specializing  in  dietary  services.  The  Company  also
offers clinical consulting services to facilities which if contracted is a service bundled within the monthly service provided to clients. Upon beginning service with
a client facility, the Company will typically hire and train the employees previously employed by such facility and assign an on-site manager to supervise and train
the front-line personnel and coordinate dietitian services with other facility support functions in accordance with client requests. Such management personnel also
oversee the execution of various cost- and quality-control procedures including continuous training and employee evaluation.

Revenue Recognition

Substantially  all  of  the  Company's  revenues  are  derived  from  contracts  with  customers.  The  Company  accounts  for  revenue  from  contracts  with  customers  in
accordance with ASC 606, and as such, the Company recognizes revenue to depict the transfer of promised goods and services to customers in amounts that reflect
the  consideration  to  which  the  Company  expects  to  be  entitled  in  exchange  for  those  goods  and  services.  The  Company’s  costs  of  obtaining  contracts  are  not
material.

The Company performs services and provides goods in accordance with contracts with its customers. Such contracts typically provide for a renewable one year
service term, cancelable by either party upon 30 to 90 days' notice, after an initial period of 60 to 120 days. A performance obligation is a promise in a contract to
transfer a distinct good or service to the customer and is defined as the unit of account under ASC 606. The Company’s Housekeeping and Dietary contracts relate
to the provision of bundles of goods, services or both, which represent a series of distinct goods and services and that are substantially the same and that have the
same pattern of transfer to the customer. Accordingly, the Company accounts for the series as a single performance obligation satisfied over time, as the customer
simultaneously receives and consumes the benefits of the goods and services provided. Revenue is recognized using the output method, which is based upon the
delivery of goods and services to the clients’ facilities. In limited cases, the Company provides goods, services or both, before the execution of a written contract.
In  these  cases,  the  Company  defers  the  recognition  of  revenue  until  a  contract  is  executed.  The  amount  of  such  deferred  revenue  was  $0.2  million  as  of
December 31, 2018. There were no such deferred revenues as of December 31, 2017

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The transaction price is the amount of consideration to which the Company expects to be entitled in exchange for transferring promised goods or services to its
customers. The transaction price does not include taxes assessed or collected. The Company’s contracts detail the fees that the Company charges for the goods and
services it provides. For certain contracts which contain a variable component to the transaction price, the Company is required to make estimates of the amount of
consideration to which the Company will be entitled, based on variability in resident and patient populations serviced, product usage or quantities consumed. The
Company recognizes revenue related to such estimates only when management determines that there will not be a significant reversal in the amount of revenue
recognized.  The  Company’s  contracts  generally  do  not  contain  significant  financing  components,  as  the  contracts  contain  payment  terms  that  are  less  than  one
year.

The Company allocates the transaction price to each performance obligation, noting that the bundle of goods, services or goods and services provided under each
Housekeeping and Dietary contract represents  a single performance  obligation  that is satisfied over time. The Company recognizes  the related  revenue when it
satisfies the performance obligation by transferring a bundle of promised goods, services or both to a customer. Such recognition is on a monthly or weekly basis,
as  goods  are  provided  and  services  are  performed.  The  time  between  completion  of  the  performance  obligation  and  collection  of  cash  is  consistent  with  the
customers'  payment  terms  and  typically  not  more  than  30-60  days.  In  certain  contractual  arrangements,  the  Company  requires  customers  to  pay  in  advance  for
goods and services to be provided. As of December 31, 2018, the value of the associated contract liabilit ies for such collections in advance was  $4.6 million. As
of December 31, 2017, the Company did not have any such contract liabilities.

Remaining Performance Obligations

The Company recognizes revenue as it satisfies the performance obligations associated with contracts with customers, which due to the nature of the goods and
services provided by the Company, are satisfied over time. Contracts may contain transaction prices that are fixed, variable or both. The significant majority of the
Company’s contracts with customers have an initial term of one year or less, with a renewable one year service term, cancelable by either party upon 30 to 90 days’
notice after an initial period of 60 to 120 days. For the purpose of disclosing future revenues under its remaining performance obligations, the Company elected to
apply practical expedients available under the guidance in ASC 606 to exclude from the calculation future revenues expected for the performance of services under
contracts with variable consideration that are for a term of one year or less. Although only a small portion of the Company’s contracts have an original expected
duration that exceeds one year, the Company has historically had, and expects to continue to have, favorable client retention rates. As of December 31, 2018, the
revenue expected to be recognized from remaining performance obligations under the Company’s existing contracts with a term greater than one year is $186.2
million for 2019, $186.2 million for 2020, $186.2 million for 2021, $186.2 million for 2022, $186.2 million for 2023, and $31.0 million thereafter

Note 3—Changes in Accumulated Other Comprehensive Income by Component

For  the  years  ended  December  31,  2018,  2017  and  2016,  the  Company’s  other  comprehensive  income  related  to  the  unrealized  gains  and  losses  from  the
Company’s available-for-sale marketable securities.

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The following table provides a summary of changes in accumulated other comprehensive income, net of taxes:

Unrealized Gains and (Losses) on Available-for Sale-Securities  1
2017

2016

2018

Accumulated other comprehensive income (loss) — beginning balance

Other comprehensive (loss) income before reclassifications

Losses reclassified from other comprehensive income  2

Net current period other comprehensive (loss) income  3

Accumulated other comprehensive income (loss) — ending balance

$

$

(in thousands) 

837  $

(319) $

(844)

165 

(679)

1,149 

7 

1,156 

158  $

837  $

543 

(1,005)

143 

(862)

(319)

1 

2 

3 

All amounts are net of tax.
Realized  losses  were  recorded  pre-tax  under  “Other  income,  net  -  Investment  and  interest”  in  our  Consolidated  Statements  of Comprehensive  Income.  For  the years
ended December 31, 2018, 2017 and 2016 the Company recorded $0.2 million, less than $0.1 million and $0.2 million of realized losses from the sale of available-for-
sale securities, respectively. Refer to Note 6—Fair Value Measurements herein for further information.
For the years ended  December 31, 2018 and 2016, the changes in other comprehensive income were net of a tax benefit of $0.1 million and $0.5 million, respectively.
For the year ended December 31, 2017 the changes in other comprehensive income were net of a tax expense of $0.3 million.

For the Year Ended December 31,
Losses from the sale of available-for-sale securities

Tax benefit

Net loss reclassified from accumulated other comprehensive income

Note 4—Property and Equipment

Amounts Reclassified from Accumulated Other
Comprehensive Income 

2018

2017

2016

(in thousands) 

$

$

197  $

(32)

165  $

11  $

(4)

7  $

222 

(79)

143 

Property and equipment are recorded at cost. Depreciation is computed using the straight-line method and is recorded over the estimated useful life of each class of
depreciable  asset.  Leasehold  improvements  are  amortized  over  the  shorter  of  the  estimated  asset  life  or  term  of  the  lease.  Repairs  and  maintenance  costs  are
charged to expense as incurred.

The following table sets forth the amounts of property and equipment by each class of depreciable asset as of December 31, 2018 and December 31, 2017:

December 31, 2018

December 31, 2017

Housekeeping and Dietary equipment

Computer hardware and software

Other 1
Total property and equipment, at cost

Less accumulated depreciation

Total property and equipment, net

$

$

(in thousands) 

22,596  $

12,114 

920 

35,630 

22,730 

12,900  $

22,349 

12,665 

990 

36,004 

22,495 

13,509 

1 

Includes furniture and fixtures, leasehold improvements and autos and trucks.

Depreciation expense for the years ended December 31, 2018, 2017 and 2016 was $4.9 million, $5.0 million and $4.8 million, respectively. 

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Note 5—Goodwill and Other Intangible Assets

Goodwill

Goodwill  represents  the  excess  of  the  purchase  price  over  the  fair  value  of  net  assets  of  acquired  businesses.  Goodwill  is  not  amortized,  but  is  evaluated  for
impairment on an annual basis, or more frequently if impairment indicators arise. To date, the Company has not recognized an impairment of its goodwill. 

Goodwill by reportable operating segment, as described in Note 15—Segment Information, was approximately $42.4 million and $8.7 million for Housekeeping
and Dietary, respectively, as of December 31, 2018 and 2017.

Intangible
Assets

The Company’s intangible assets consist of customer relationships which were obtained through acquisitions and are recorded at their fair values at the date of
acquisition.  Intangible  assets  with  determinable  lives  are  amortized  on  a  straight-line  basis  over  their  estimated  useful  lives.  The  customer  relationships  have  a
weighted-average amortization period of 9.9 years.

The following table sets forth the estimated amortization expense for intangibles subject to amortization for the next five years and thereafter:

Period/Year 

2019

2020

2021

2022

2023

Thereafter

Total Amortization Expense 
(in thousands)

4,165 

4,165 

4,165 

4,165 

3,168 

6,690 

$

$

$

$

$

$

Amortization expense for the years ended December 31, 2018, 2017 and 2016 was $4.4 million, $3.9 million and $2.7 million, respectively.

Note 6—Fair Value Measurements

The  Company’s  current  assets  and  current  liabilities  are  financial  instruments  and  most  of  these  items  (other  than  marketable  securities  and  inventories)  are
recorded at cost in the Consolidated Balance Sheets. The estimated fair value of these financial instruments approximates their carrying value due to their short-
term  nature.  The  carrying  value  of  the  Company’s  line  of  credit  represents  the  outstanding  amount  of  the  borrowings,  which  approximates  fair  value.  The
Company’s  financial  assets  that  are  measured  at  fair  value  on  a  recurring  basis  are  its  marketable  securities  and  deferred  compensation  funding.  The  recorded
values  of  all  of  the  financial  instruments  approximate  their  current  fair  values  because  of  their  nature,  stated  interest  rates  and  respective  maturity  dates  or
durations.

The Company’s marketable securities consist of tax-exempt municipal bonds, which are classified as available-for-sale and are reported at fair value. Unrealized
gains and losses associated with these investments are included in other comprehensive income (net of tax) within the Consolidated Statements of Comprehensive
Income. The fair value of these marketable securities is classified within Level 2 of the fair value hierarchy, as these securities are measured using quoted prices
for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant assumptions are observable. Such
valuations are determined by a third-party pricing service. For the years ended December 31, 2018, 2017 and 2016, the Company recorded unrealized losses of
$0.7 million, unrealized gains of $1.2 million and unrealized losses of $0.9 million on marketable securities, respectively.

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For the years ended December 31, 2018, 2017 and 2016, the Company received total proceeds, less the amount of interest received, of $9.0 million, $28.5 million
and $28.1 million, respectively, from sales of available-for-sale municipal bonds. These sales resulted in realized losses of $0.2 million, less than $0.1 million and
$0.2 million for the years ended December 31, 2018, 2017, and 2016 respectively. Such losses were recorded in “Other income-Investment and interest” in the
Consolidated Statements of Comprehensive Income. The basis for the sale of these securities was the specific identification of each bond sold during the period.

The investments under the funded deferred compensation plan are accounted for as trading securities and unrealized gains or losses are included in earnings. The
fair value of these investments are determined based on quoted market prices (Level 1).

The following tables provide fair value measurement information for the Company’s marketable securities and deferred compensation fund investment assets as of
December 31, 2018 and 2017:

Carrying 
Amount 

Total Fair 
Value 

As of December 31, 2018

Fair Value Measurement Using: 

Quoted 
Prices 
in Active 
Markets 
(Level 1) 

(in thousands) 

Significant 
Other 
Observable 
Inputs 
(Level 2) 

Significant 
Unobservable 
Inputs 
(Level 3) 

Financial Assets: 

Marketable securities 

Municipal bonds — available-for-sale 

$

76,362  $

76,362  $

—  $

76,362  $

Deferred compensation fund 

Money Market 1
Balanced and Lifestyle 

Large Cap Growth 

Small Cap Growth 

Fixed Income 

International 

Mid Cap Growth 

2,529 

8,265 

8,195 

3,217 

3,432 

1,485 

1,990 

2,529 

8,265 

8,195 

3,217 

3,432 

1,485 

1,990 

— 

8,265 

8,195 

3,217 

3,432 

1,485 

1,990 

2,529 

— 

— 

— 

— 

— 

— 

Deferred compensation fund 

$

29,113  $

29,113  $

26,584  $

2,529  $

— 

— 

— 

— 

— 

— 

— 

— 

— 

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Carrying 
Amount 

Total Fair 
Value 

As of December 31, 2017

Fair Value Measurement Using: 

Quoted 
Prices 
in Active 
Markets 
(Level 1) 

(in thousands) 

Significant 
Other 
Observable 
Inputs 
(Level 2) 

Significant 
Unobservable 
Inputs 
(Level 3) 

Financial Assets: 

Marketable securities 

Municipal bonds — available-for-sale 

Deferred compensation fund 

Money Market 1
Balanced and Lifestyle 

$

$

Large Cap Growth 

Small Cap Value 

Fixed Income 

International 

Mid Cap Growth 

73,221  $

73,221  $

—  $

73,221  $

2,720  $

2,720  $

—  $

2,720  $

8,523 

7,802 

3,442 

3,050 

1,531 

1,817 

8,523 

7,802 

3,442 

3,050 

1,531 

1,817 

8,523 

7,802 

3,442 

3,050 

1,531 

1,817 

— 

— 

— 

— 

— 

— 

Deferred compensation fund 

$

28,885  $

28,885  $

26,165  $

2,720  $

— 

— 

— 

— 

— 

— 

— 

— 

— 

1 

The fair value of the money market fund is based on the net asset value (“NAV”) of the shares held by the plan at the end of the period. The money market fund includes
short-term  United  States  dollar  denominated  money-market  instruments  and  the  NAV  is  determined  by  the  custodian  of  the  fund.  The  money  market  fund  can  be
redeemed at its NAV at the measurement date, as there are no significant restrictions on the ability to sell this investment.

Amortized Cost 

Gross Unrealized
Gains 

Gross Unrealized
Losses 

(in thousands) 

Estimated Fair Value 

Other-Than-Temporary
Impairments 

December 31, 2018

Marketable securities 

Municipal bonds — available-for-sale 

Total debt securities 

December 31, 2017

Marketable securities

Municipal bonds — available-for-sale 

Total debt securities 

December 31, 2016

Marketable securities

Municipal bonds — available-for-sale 

Total debt securities 

$

$

$

$

$

$

76,162  $

76,162  $

633  $

633  $

(433) $

(433) $

76,362  $

76,362  $

72,249  $

72,249  $

1,169  $

1,169  $

(197) $

(197) $

73,221  $

73,221  $

68,220  $

68,220  $

178  $

178  $

(668) $

(668) $

67,730  $

67,730  $

— 

— 

— 

— 

— 

— 

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The following table summarizes the contractual maturities of debt securities held at December 31, 2018 and 2017, which are classified as marketable securities in
the Consolidated Balance Sheets:

Contractual maturity: 
Maturing in one year or less

Maturing in second year through fifth year

Maturing in sixth year through tenth year

Maturing after ten years

Total debt securities

Note 7— Accounts and Notes Receivable

Municipal Bonds — Available-for-Sale 
December 31,

2018

2017

(in thousands) 

$

$

1,645  $

24,649 

14,769 

35,299 

76,362  $

916 

15,948 

22,851 

33,506 

73,221 

The Company’s accounts and notes receivable balances consisted of the following as of December 31, 2018 and 2017:

Short-term 

Accounts and notes receivable 

Allowance for doubtful accounts 

Total net short-term accounts and notes receivable 

Long-term 

Notes receivable 

Allowance for doubtful accounts 

Total net long-term notes receivable 

Total net accounts and notes receivable 

December 31, 2018

December 31, 2017

(in thousands) 

$

$

389,047  $

(47,209)

341,838 

53,043 

(10,000)

43,043 

384,881  $

390,705 

(11,985)

378,720 

15,476 

— 

15,476 

394,196 

The Company makes credit decisions on a case–by–case basis after reviewing a number of qualitative and quantitative factors related to the specific client as well
as  current  industry  variables  that  may  impact  that  client.  There  are  a  variety  of  factors  that  impact  a  client’s  ability  to  pay  in  accordance  with  the  Company’s
service agreements. These factors include, but are not limited to, fluctuating census numbers, litigation costs and the client’s participation in programs funded by
federal and state governmental agencies. Deviations in the timing or amounts of reimbursements under those programs can impact the client’s cash flows and their
ability  to  make  timely  payments.  However,  the  client's  obligation  to  pay  the  Company  in  accordance  with  the  service  agreements  are  not  contingent  upon  the
client’s cash flows. Notwithstanding the Company’s efforts to minimize its credit risk exposure, the aforementioned factors, as well as other factors that impact
client  cash  flows  or  ability  to  make  timely  payments,  could  have  an  indirect,  yet  material  adverse  effect  on  the  Company’s  results  of  operations  and  financial
condition.

The  Company’s  net  current  accounts  and  notes  receivable  balance  decreased  from  December  31,  2017.  Fluctuations  in  net  accounts  and  notes  receivable  are
generally attributable to a variety of factors including, but not limited to, the timing of cash receipts from customers and the inception, transition, modification or
termination  of  client  relationships.  However,  the  Company  offset  its  accounts  and  notes  receivable  with an increased  allow ance for doubtful accounts in 2018
related to multiple corporate restructurings of privately-held, multi-facility operators that occurred during 2018 that resulted in increased expense compared to our
historical  experience.  In  addition,  the  Company  converted  approximately  $24.8  million  of  accounts  receivable  to  long-term  notes  receivable.  Additionally,  in
2018 the Company finalized an agreement for a long-term promissory note receivable related to the previously mentioned corporate restructurings. The promissory
note receivable  was $10.0 million, net of reserve which has been classified  as a long-term notes receivable  on the Company's balance sheet for the year ended
December 31, 2018.

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The Company deploys significant resources and has invested in tools and processes to optimize management’s credit and collections efforts. When appropriate, the
Company utilizes interest-bearing promissory notes as an alternative to accounts receivable to enhance the collectability of amounts due, by instituting a definitive
repayment plan and providing a means by which to further evidence the amounts owed. As of December 31, 2018 and 2017, the Company had $63.3 million and
$36.6 million, net of reserves, respectively, of such promissory notes outstanding. In addition, the Company may assist clients who are adjusting to changes in their
cash  flows  by  amending  the  Company’s  agreements  from  full-service  to  management-only  arrangements,  or  by  modifying  contractual  payment  terms  to
accommodate  clients  who  have  in  good  faith  established  clearly-defined  plans  for  addressing  cash  flow  issues.  These  efforts  are  intended  to  minimize  the
Company’s collections risk while maintaining relationships with the clients.

Note 8 — Allowance for Doubtful Accounts

The allowance for doubtful accounts is established when the Company determines that it is probable that receivables have been impaired and the Company can
reasonably  estimate  the  amount  of  the  losses.  The  related  provision  for  bad  debts  is  charged  to  costs  of  services  provided  in  the  Company’s  Consolidated
Statements of Comprehensive Income. The allowance for doubtful accounts is evaluated based on the Company’s ongoing review of accounts and notes receivable
and is inherently subjective as it requires estimates susceptible to significant revision as more information becomes available.

The  Company  has  had  varying  collections  experience  with  respect  to  its  accounts  and  notes  receivable.  The  Company  has  sometimes  extended  the  period  of
payment for certain clients beyond contractual terms. Such clients include those who have terminated service agreements and slow payers experiencing financial
difficulties. In order to provide for these collection problems and the general risk associated with the granting of credit terms, the Company recorded the following
bad debt provisions (in an Allowance for Doubtful Accounts):

2018

Year Ended December 31,

2017

(in thousands) 

2016

Bad debt provision

$

51,387  $

6,250  $

4,629 

The increase to the bad debt provision for 2018 related to multiple corporate restructurings of privately-held, multi-facility operators that occurred during 2018 that
resulted in increased expense compared to the Company's historical experience.
In making the Company’s credit evaluations, in addition to analyzing and anticipating, where possible, the specific cases described above, management considers
the general collection risk associated with trends in the long-term care industry. The Company establishes credit limits, performs ongoing credit evaluations and
monitors  accounts  to  minimize  the  risk  of  loss.  Despite  the  Company’s  efforts  to  minimize  credit  risk  exposure,  clients  could  be  adversely  affected  if  future
industry trends change in such a manner as to negatively impact their cash flows. If the Company’s clients experience a negative impact on their cash flows, it
could have a material adverse effect on the Company’s results of operations and financial condition.

Impaired Notes Receivable

The Company evaluates its notes receivable for impairment quarterly and on an individual client basis. Notes receivable are generally evaluated for impairment
when the respective clients are in bankruptcy, are subject to collections activity or are slow payers that are experiencing financial difficulties. In the event that the
evaluation results in a determination that a note receivable is impaired, it is valued at the present value of expected future cash flows or at the market value of
related collateral. The increase in impaired notes receivable and the related reserve during the year ended December 31, 2018 related to the corporate restructuring
of a privately  held, multi-state  operator  that occurred  during 2018. A result of the corporate  restructuring  was a long-term  promissory note receivable  of $10.0
million, net of reserve. Summary schedules of impaired notes receivable, and the related reserve, for the years ended December 31, 2018, 2017 and 2016 are as
follows:

Impaired Notes Receivable

Year Ended December 31,

Balance Beginning of
Year

Additions

Deductions

Balance End of Year

Average Outstanding
Balance

2018

2017

2016

$

$

$

6,854  $

5,685  $

6,471  $

23,382  $

1,169  $

—  $

4,532  $

—  $

786  $

25,704  $

6,854  $

5,685  $

15,448 

6,270 

6,078 

(in thousands)

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Year Ended December 31,

2018

2017

2016

Reserve for Impaired Notes Receivable

Balance Beginning of
Year

$

$

$

2,884  $

2,419  $

2,139  $

Additions

Deductions

Balance End of Year

(in thousands)

12,526  $

465  $

280  $

1,938  $

—  $

—  $

13,472 

2,884 

2,419 

For  impaired  notes  receivable,  interest  income  is  recognized  on  a  cost  recovery  basis  only.  As  a  result,  no  interest  income  was  recognized  on  impaired  notes
receivable.  The  Company  follows  an  income  recognition  policy  on  all  other  notes  receivable  that  do  not  recognize  interest  income  until  cash  payments  are
received. This policy was established, recognizing the environment of the long-term care industry, and not because such notes receivable are necessarily impaired.
The difference between income recognition on a full accrual basis and cash basis, for notes receivable that are not considered impaired, is not material. 

Note 9 — Lease Commitments

The Company leases office facilities, equipment and vehicles under operating leases expiring on various dates through 2025. Certain office leases contain renewal
options. The following is a schedule by calendar year of future minimum lease payments under operating leases that have remaining terms as of December 31,
2018:
Period/Year 

Operating Leases 

(in thousands) 

2019

2020

2021

2022

2023

Thereafter

Total minimum lease payments

$

$

3,203 

2,799 

1,097 

677 

677 

677 

9,130 

Total expense for all operating leases for the years ended December 31, 2018, 2017 and 2016 was as follows:

Operating lease expense

$

4,039  $

3,833  $

2,615 

Note 10— Share-Based Compensation

A summary of stock-based compensation expense and related tax benefits for the years ended December 31, 2018, 2017 and 2016 is as follows:

2018

Year Ended December 31, 

2017

(in thousands) 

2016

Stock options

Restricted stock units and restricted stock 

Employee Stock Purchase Plan

Total pre-tax stock-based compensation expense charged against income 1

Total recognized tax benefit related to stock-based compensation 

Year Ended December 31, 

2018

2017

2016

(in thousands) 

2,989  $

3,740  $

2,591 

320 

1,205 

1,040 

5,900  $

5,985  $

3,193 

550 

509 

4,252 

1,480  $

5,709  $

2,773 

$

$

$

1 

Stock-based compensation expense is recorded in the selling, general and administrative caption in the Consolidated  Statements of Comprehensive Income.

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As  of  December  31,  2018  and  2017,  the  unrecognized  compensation  cost  related  to  unvested  stock  options  and  awards  was  $14.0  million  and  $11.4  million,
respectively.  The  weighted  average  period  over  which  these  awards  will  vest  was  approximately  2.5  years  as  of  December  31,  2018  and  2.7  years  as
of December 31, 2017.

2012 Equity Incentive Plan

The Company’s 2012 Equity Incentive Plan (the “Plan”) provides that current or prospective officers, employees, non-employee directors and advisors can receive
share-based  awards  such  as  stock  options,  restricted  stock,  restricted  stock  units  and  other  stock  awards.  The  Plan  seeks  to  promote  the  highest  level  of
performance by providing an economic interest in the long-term success of the Company.

As of December 31, 2018, 2.9 million shares of Common Stock were reserved for issuance under the Plan, including 0.5 million shares available for future grant.
No stock award will have a term in excess of ten years. All awards granted under the Plan become vested and exercisable ratably over a five year period on each
yearly anniversary of the grant date.

The Nominating, Compensation and Stock Option Committee of the Board of Directors is responsible for determining the individuals who will be granted stock
awards, the number of stock awards each individual will receive and the terms of the grants in accordance with the Plan.

Stock Options

A summary of stock options outstanding under the Plan as of December 31, 2018 and changes during 2018 is as follows:

December 31, 2017

Granted

Exercised

Forfeited

Expired

December 31, 2018

Number of Shares
(in thousands) 

Weighted Average Exercise
Price

2,374  $

169  $

(351) $

(65) $

(6) $

2,121  $

29.22 

52.06 

25.12 

35.50 

27.10 

31.53 

The weighted average grant-date fair value of stock options granted during the years ended 2018, 2017 and 2016 were $10.48, $8.52 and $7.46 per common share,
respectively.  The  total  intrinsic  value  of  options  exercised  during  the  years  ended  2018,  2017  and  2016  were  $7.8  million,  $19.5  million  and  $4.9  million,
respectively. The total fair value of options vested during the years ended 2018, 2017 and 2016 were $3.7 million, $3.2 million and $2.8 million, respectively.

For the years ended December 31, 2018 and 2017 the tax benefit realized from stock options exercised were $1.0 million and $5.3 million, respectively.

The  fair  value  of  the  stock  option  awards  granted  during  2018,  2017  and  2016  were  estimated  on  the  dates  of  grant  using  the  Black-Scholes  option  valuation
model and the following assumptions:

Risk-free interest rate

Weighted average expected life

Expected volatility

Dividend yield

Year Ended December 31, 

2018 

2017 

2016 

2.1 %

5.8 years

21.5 %

1.5 %

2.0 %

5.8 years

25.1 %

1.9 %

2.0 %

5.8 years

26.0 %

2.0 %

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The following table summarizes other information about the stock options at December 31, 2018:

December 31, 2018

(amounts in thousands, except per share data)

Outstanding:

Aggregate intrinsic value

Weighted average remaining contractual life

Exercisable:

Number of options

Weighted average exercise price

Aggregate intrinsic value

Weighted average remaining contractual life

Restricted Stock Units and Restricted Stock

$

$

$

20,351 

5.9 years

1,051 

25.20 

15,750 

4.5 years

The fair value of outstanding restricted stock units and restricted stock was determined based on the market price of the shares on the date of grant. For both the
years ended December  31, 2018 and 2017, the Company granted  0.1 million  restricted  stock units with a weighted average  grant date fair  value of $52.06 and
$40.16 per unit, respectively. There were no restricted stock units granted during 2016. 

For the years ended December 31, 2018 and 2017, the Company did not grant restricted stock. For the year ended December 31, 2016 the Company granted less
than 0.1 million shares of restricted stock, with a weighted average grant date fair value of $34.14 per share.

A summary of the outstanding restricted stock units and restricted stock as of December 31, 2018 and changes during 2018 is as follows:

December 31, 2017

Granted

Vested

Forfeited

December 31, 2018

Restricted Stock Units and Restricted Stock

Number 

(in thousands) 

Weighted Average Grant Date
Fair Value 

145  $

139  $

(36) $

(7) $

241  $

37.07 

52.06 

35.79 

52.06 

45.47 

The weighted average remaining vesting period for the unvested restricted stock units and restricted stock is 3.3 years.

The weighted average grant-date fair values and total fair values of restricted stock units and restricted stock vested during 2018, 2017 and 2016 are as follows:

Weighted average grant-date fair value of restricted stock units and restricted stock granted

Total fair value of restricted stock units and restricted stock vested

$

$

52.06  $

1,822  $

40.16  $

690  $

34.14 

311 

Fair value is determined based on the market price of the shares on the date of grant. The weighted average remaining vesting period for the unvested restricted
stock is 3.3 years. 

Year Ended December 31, 

2018

2017

2016

(in thousands, except per share data)

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Employee Stock Purchase Plan

The Company's Employee Stock Purchase Plan ("ESPP") is currently available through 2021 to all eligible employees. All full-time and part-time employees who
work  an  average  of  20  hours  per  week  and  have  completed  two  years  of  continuous  service  with  the  Company  are  eligible  to  participate.  Annual  offerings
commence and terminate on the respective year’s first and last calendar day.

Under the ESPP, the Company is authorized to issue up to 4.1 million shares of Common Stock to its employees. Pursuant to such authorization, there are 2.2
million shares available for future grant at December 31, 2018. Under the terms of the ESPP, participants may contribute through payroll deductions up to $21,250
(85% of IRS limitation) of their compensation toward the purchase of the Company’s Common Stock. No employee may purchase Common Stock which exceeds
$25,000 in fair market value (determined on the option date) for each calendar year. The option price per share is equal to the lower of 85% of the fair market price
on the first day of the offering period, or 85% of the fair market price on the last day of the offering period.

The following table summarizes information about the Company’s ESPP annual offerings for the years ended December 31, 2018, 2017 and 2016:

Common shares purchased

Per common share purchase price

Deferred Compensation Plan

Year Ended December 31,

2018

2017

2016

(in thousands, except per share data)
53 

54 

$

34.15  $

33.29  $

53 

29.64 

The Company offers a Supplemental Executive Retirement Plan (“SERP”) for certain key executives and employees. The SERP is not qualified under Section 401
of the Internal Revenue Code. The SERP allows participants to defer up to 25% of their earned income on a pre-tax basis and as of the last day of each plan year,
each participant will be credited with a 25% match of up to 15% of their deferral in the form of Company Common Stock based on the then-current market value.
SERP participants fully vest in the Company’s matching contribution three years from the first day of the initial year of participation. The income deferred and the
matching contributions are unsecured and subject to the claims of the Company’s general creditors.

Under the SERP, the Company is authorized to issue up to 1.0 million shares of Common Stock to its employees. Pursuant to such authorization, there are 0.4
million shares available for future grant at December 31, 2018. At the time of issuance, such shares were accounted for at cost as treasury stock. At December 31,
2018, approximately 0.3 million of such shares are vested and remain in the respective active participants’ accounts with the trustee.

The following table summarizes information about the SERP for the plan years ended December 31, 2018, 2017 and 2016:

SERP expense   1

Treasury shares issued to fund SERP expense 2

SERP trust account balance at December 31 3
Unrealized gain (loss) recorded in SERP liability account

2018

Year Ended December 31,

2017

(in thousands) 

2016

$

$

$

547  $

14 

39,766  $

(1,469) $

503  $

9 

42,467  $

4,534  $

511 

13 

34,599 

1,495 

1 

2 

3 

Both the SERP match and the deferrals are included in the selling, general and administrative caption in the  Consolidated Statements of Comprehensive Income.
Shares related to the SERP match for each year are funded at the beginning of the subsequent year.
SERP trust account investments are recorded at their fair value which is based on quoted market prices. Differences between such amounts in the table above and the
deferred compensation funding asset reported on the Consolidated Balance Sheets represent the value of Company Common Stock held in the Plan participants’ trust
accounts and reported by the Company as treasury stock in the Consolidated Balance Sheets.

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Note 11— Other Employee Benefit Plans

Retirement Savings Plan

Since October 1, 1999, the Company has had a retirement savings plan for eligible employees (the “RSP”) under Section 401(k) of the Internal Revenue Code. The
RSP allows eligible employees to contribute up to 15% of their eligible compensation on a pre-tax basis. There is no match by the Company.

Note 12— Dividends

The Company has paid regular quarterly cash dividends since the second quarter of 2003. During 2018, the Company paid regular quarterly cash dividends totaling
$57.2 million as detailed below:

March 31, 2018

June 30, 2018

September 30, 2018

December 31, 2018 

(in thousands, except per share amounts)

Quarter Ended 

Cash dividends paid per common share

Total cash dividends paid

$

$

Record date

Payment date

0.19125  $

14,149  $

February 16, 2018

March 23, 2018

0.19250  $

14,249  $

May 25, 2018

June 29, 2018

0.19375  $

14,350  $

0.19500 

14,453 

August 24, 2018

November 23, 2018

September 28, 2018

December 28, 2018

Additionally, on February 5, 2019, the Company’s Board of Directors declared a regular quarterly cash dividend of $0.19625 per common share, which will be
paid on March 22, 2019 to shareholders of record as of the close of business on February 15, 2019.

Cash dividends declared on the Company’s outstanding weighted average number of basic common shares for the years ended December 31, 2018, 2017 and 2016
were as follows:

Cash dividends declared per common share

Note 13— Income Taxes

The following table summarizes the provision for income taxes:

Current:

Federal

State

Deferred:

Federal

State

Tax provision

Year Ended December 31, 

2018

2017

2016

$

0.77750  $

0.75750  $

0.73750 

Year Ended December 31, 

2018

2017

(in thousands) 

2016

23,407  $

35,673  $

5,992 

29,399 

(9,526)

(3,487)

(13,013)

7,179 

42,852 

2,924 

(1,037)

1,887 

16,386  $

44,739  $

33,032 

6,958 

39,990 

2,163 

838 

3,001 

42,991 

$

$

Deferred  income  taxes  are  recorded  using  the  asset  and  liability  method.  Deferred  tax  assets  and  liabilities  are  determined  based  on  differences  between  the
financial reporting and income tax basis of assets and liabilities.

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On December 22, 2017, the Tax Cuts and Jobs Act was signed into law, enacting significant changes to corporate tax rates, as well as business-related exclusions,
deductions and credits. The primary impact to the Company was the decrease in the U.S. federal corporate income tax rate from 35% to 21%. Accordingly, during
the  fourth  quarter  2017,  the  Company  recognized  the  effects  of  the  changes  in  the  tax  law  and  rates  on  its  deferred  tax  balances.  The  net  result  of  the
remeasurement  was  an  approximately  $4.5  million  decrease  to  the  Company’s  net  deferred  tax  assets  balance  and  a  corresponding  increase  to  the  Company’s
provision for income taxes for the year ended December 31, 2017.

Significant components of the Company’s federal and state deferred tax asset and liability balances are as follows:

Deferred tax assets: 

Allowance for doubtful accounts 

Deferred compensation 

Accrued insurance claims 

Non-deductible reserves 

Amortization of intangibles 

Other 

Deferred tax liabilities: 

Expensing of housekeeping supplies 

Depreciation of property and equipment 

Other 

Year Ended December 31,

2018

2017

(in thousands) 

$

14,599  $

7,350 

3,715 

336 

24 

1,730 

27,754 

(4,375)

(1,913)

(914)

(7,202)

3,109 

6,601 

3,665 

567 

162 

662 

14,766 

(4,678)

(1,745)

(845)

(7,268)

Net deferred tax assets 

$

20,552  $

7,498 

Realization of the Company’s deferred tax assets is dependent upon future earnings in specific tax jurisdictions, the timing and amount of which are uncertain.
Management  assesses  the  Company’s  income  tax  positions  and  records  tax  benefits  for  all  years  subject  to  examination  based  upon  an  evaluation  of  the  facts,
circumstances,  and  information  available  at  the  reporting  dates,  which  include  historical  operating  results  and  expectations  of  future  earnings.  As  such,
management  believes  it  is  more  likely  than  not  that  the  deferred  tax  assets  recorded  will  be  realized  to  reduce  future  income  taxes  and  therefore  no  valuation
allowances are necessary.

The table below provides a reconciliation between the tax expense computed by applying the statutory federal income tax rate to income before income taxes and
the provision for income taxes:

Income tax expense computed at statutory rate

Increases (decreases) resulting from:

State income taxes, net of federal tax benefit

Federal jobs credits

Tax exempt interest

Stock-based compensation

United States Tax Reform - remeasurement of deferred taxes

Other, net

Income tax expense

2018

Year Ended December 31, 

2017

(in thousands) 

2016

$

20,981  $

46,538  $

42,136 

1,936 

(5,006)

(384)

(1,179)

— 

38 

3,661 

(4,193)

(568)

(4,632)

3,719 

214 

5,064 

(4,550)

(457)

653 

— 

145 

$

16,386  $

44,739  $

42,991 

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The  Company  performs  an  evaluation  each  period  of  its  tax  positions  taken  and  expected  to  be  taken  in  tax  returns.  The  evaluation  is  performed  on  positions
relating to tax years that remain subject to examination by major tax jurisdictions, the earliest of which is the tax year ended December 31, 2013. Based on the
evaluation, the Company concluded that there are no significant uncertain tax positions requiring recognition in the Company’s financial statements. Therefore, the
table reporting on the change in the liability for unrecognized tax benefits during the years ended December 31, 2018 and 2017 is omitted as there is no activity to
report in such account for the years ended December 31, 2018 or 2017.

Note 14—Related Party Transactions

For the year ended December 31, 2018, the Company did not have any related party transactions. For the years ended December 31, 2017 and 2016, a director was
a member of a law firm which was retained by the Company. The fees paid by the Company to such firm did not exceed $120,000 in any period. Additionally,
such fees did not exceed, in any period, 5% of such firm’s revenues or the Company’s revenues.

Note 15—Segment Information 

Reportable Operating Segments

The  Company  manages  and  evaluates  its  operations  in  two  reportable  segments:  Housekeeping  (housekeeping,  laundry,  linen  and  other  services)  and  Dietary
(dietary  department  services).  Although  both  segments  serve  the  same  client  base  and  share  many  operational  similarities,  they  are  managed  separately  due  to
distinct  differences  in  the  type  of  services  provided,  as  well  as  the  specialized  expertise  required  of  the  professional  management  personnel  responsible  for
delivering each segment’s services. Such services are rendered pursuant to discrete service agreements, specific to each reportable segment.

The Company’s accounting policies for the segments are generally the same as described in the Company’s significant accounting policies. Differences between
the reportable segments’ operating results and other disclosed data and the information in the Consolidated Financial Statements relate primarily to corporate level
transactions and recording of transactions at the reportable segment level using other than generally accepted accounting principles. There are certain inventories
and  supplies  that  are  primarily  expensed  when  incurred  within  the  operating  segments,  while  they  are  capitalized  in  the  Consolidated  Financial  Statements.  In
addition, most corporate expenses such as corporate salary and benefit costs, certain legal costs, information technology costs, depreciation, amortization of finite-
lived intangible assets, share based compensation costs and other corporate-specific costs, are not allocated to the operating segments. There are also allocations for
workers’  compensation  and  general  liability  expense  within  the  operating  segments  that  differ  from  the  actual  expense  recorded  by  the  Company  under  U.S.
GAAP. Segment amounts disclosed are prior to elimination entries made in consolidation.

All revenues and net income are earned in the United States.

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Revenues 1

Housekeeping services

Dietary services

Corporate and eliminations

Consolidated

Income before income taxes 

Housekeeping services 2
Dietary services

Corporate and eliminations 3
Consolidated

Depreciation and amortization 

Housekeeping services

Dietary services

Corporate and eliminations

Consolidated

Total assets 

Housekeeping services

Dietary services

Corporate and eliminations 4
Consolidated

Capital expenditures 

Housekeeping services

Dietary services

Corporate and eliminations

Consolidated

2018

Year Ended December 31, 

2017

(in thousands)

2016

973,826  $

1,034,995 

—  $

979,610  $

886,521 

—  $

957,148 

605,514 

— 

2,008,821  $

1,866,131  $

1,562,662 

108,305  $

60,562 

(68,957)

99,910  $

6,315  $

2,433 

524 

9,272  $

291,117  $

235,183 

166,303 

692,603  $

3,996  $

690 

254 

4,940  $

95,505  $

46,008 

(8,548)

132,965  $

6,547  $

1,813 

526 

8,886  $

304,303  $

242,874 

128,826 

676,003  $

4,287  $

663 

447 

5,397  $

90,756 

34,641 

(5,010)

120,387 

6,535 

439 

522 

7,496 

266,464 

127,187 

134,795 

528,446 

4,612 

410 

420 

5,442 

$

$

$

$

$

$

$

$

$

$

$

1 

2 

3 

4 

F or the years ended December 31, 2018 and 2017, both the Housekeeping and Dietary segments earned revenue from several significant customers, including Genesis.
For the years ended December 31, 2018 and 2017, Genesis accounted for $386.7 million or 19.3% and $327.5 million or 17.5% of the Company's consolidated revenues,
respectively.
Includes  the impact of the revenues earned and expenses incurred from the Voluntary Benefits Program of the Company's wholly-owned captive insurance subsidiary.
Represents primarily corp orate office cost and related overhead, recording of certain inventories and supplies and workers compensation costs at the reportable segment
level which use accounting methods that differ from those used at the corporate level, as well as consolidated subsidiaries’ operating expenses that are not allocated to the
reportable segments, net of investment and interest income.
Primarily consists of cash and cash equivalents, marketable securities, deferred income taxes and other current and noncurrent assets.

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Note 16— Earnings Per Common Share

Basic  and  diluted  earnings  per  common  share  are  computed  by  dividing  net  income  by  the  weighted-average  number  of  basic  and  diluted  common  shares
outstanding, respectively. The weighted-average number of diluted common shares includes the impact of dilutive securities, including outstanding stock options
and unvested restricted stock and restricted stock units. The table below reconciles the weighted-average basic and diluted common shares outstanding for 2018,
2017 and 2016:

Weighted average number of common shares outstanding - basic

Effect of dilutive securities 1

Weighted average number of common shares outstanding - diluted

Year Ended December 31, 2018

2018 

2017 

(in thousands) 

2016 

74,002 

610 

74,612 

73,355 

993 

74,348 

72,754 

720 

73,474 

1 

Certain  outstanding  equity  awards  are  anti-dilutive  and  were  therefore  excluded  from  the  calculation  of  the  weighted  average  number  of  diluted  common  shares
outstanding. For the year ended December 31, 2018, 2017 and 2016, options to purchase 0.6 million, less than 0.1 million shares and 0.5 million shares were excluded
from the calculation of weighted average number of diluted common shares outstanding, respectively. The per share exercise prices of such awards were $42.84, $39.38
and $34.14, respectively. 

Note 17—Contractual Obligations and Other Contingencies

Line of Credit

As of December 31, 2018, the Compa ny had a $475 million bank line of credit on which to draw for general corporate purposes. Amounts drawn under the line of
credit are payable upon demand and generally bear interest at a floating rate, based on the Company's leverage ratio, and starting at LIBOR plus 115 basis points
(or if LIBOR becomes unavailable, the higher of the Overnight Bank Funding Rate, plus 50 basis points and the Prime Rate). At December 31, 2018, there were
$30.0 million in borrowings under the line of credit. The line of credit requires the Company to satisfy two financial covenants, with which the Company is in
compliance as of December 31, 2018 and expects to remain in compliance. The line of credit expires on December 21, 2023.

At December 31, 2018, the Company also had outstanding $65.9 million in irrevocable  standby letters of credit, which relate to payment obligations under the
Company's insurance programs. In connection with the issuance of the letters of credit, the amount available under the line of credit was further reduced by $65.9
million at December 31, 2018. On January 2, 2019, the letters of credit were amended and decreased the outstanding amounts to $62.7 million. The letters of credit
expire on January 2, 2020.

Tax Jurisdictions and Matters

The Company provides services throughout the continental United States and is subject to numerous state and local taxing jurisdictions. In the ordinary course of
business, a jurisdiction may contest the Company’s reporting positions with respect to the application of its tax code to the Company’s services, which could result
in additional tax liabilities.

The  Company  has  tax  matters  with  various  taxing  authorities.  Because  of  the  uncertainties  related  to  both  the  probable  outcomes  and  amount  of  probable
assessments due, the Company is unable to make a reasonable estimate of a liability. The Company does not expect the resolution of any of these matters, taken
individually  or  in  the  aggregate,  to  have  a  material  adverse  effect  on  the  consolidated  financial  position  or  results  of  operations  based  on  the  Company’s  best
estimate of the outcomes of such matters.

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Legal Proceedings

The Company is subject to various claims and legal actions in the ordinary course of business. Some of these matters include payroll and employee-related matters
and examinations by governmental agencies. As the Company becomes aware of such claims and legal actions, the Company records accruals for any exposures
that  are  probable  and  estimable.  If  adverse  outcomes  of  such  claims  and  legal  actions  are  reasonably  possible,  management  assesses  materiality  and  provides
financial  disclosure,  as  appropriate.  The  Company  believes  it  is  not  a  party  to,  nor  are  any  of  its  properties  the  subject  of,  any  pending  legal  proceeding  or
governmental examination that would have a material adverse effect on the Company’s consolidated financial condition or liquidity.

Government Regulations

The Company’s clients are concentrated in the healthcare industry and are primarily providers of long-term care. The revenues of many of the Company’s clients
are highly reliant on Medicare, Medicaid and third party payors’ reimbursement funding rates. New legislation or additional changes in existing regulations could
directly impact the governmental reimbursement programs in which the clients participate. The full effect of any such programs would not be realized until these
laws are fully implemented and government agencies issue applicable regulations or guidance.

Note 18—Accrued Insurance Claims

The Company currently has a Paid Loss Retrospective Insurance Plan for general liability and workers’ compensation insurance, which comprise approximately
31.6% of the Company’s liabilities at December 31, 2018. Under the Company’s insurance plans for general liability and workers’ compensation, predetermined
loss  limits  are  arranged  with  the  Company’s  insurance  company  to  limit  both  per  occurrence  cash  outlay  and  annual  insurance  plan  cost.  The  Company’s
accounting  for  this  plan  utilizes  current  valuations  from  a  third  party  actuary,  which  include  assumptions  based  on  data  such  as  historical  claims,  pay-out
experience,  demographic  factors,  industry  trends,  severity  factors,  and  other  actuarial  calculations.  In  the  event  that  the  Company’s  claims  experience  and/or
industry  trends  result  in  an  unfavorable  change  in  the  assumptions  or  outcomes,  it  would  have  an  adverse  effect  on  the  Company’s  results  of  operations  and
financial condition.

For general liability and workers’ compensation, the Company records both a reserve for the estimated future cost of claims and related expenses that have been
reported but not settled, as well as an estimate of claims incurred but not reported. Such reserves for claims incurred but not reported are developed by a third party
actuary through review of the Company’s historical data and open claims.

Note 19—Subsequent Events

The Company evaluated all subsequent events through the date of this Annual Report on Form 10-K. There were no events or transactions occurring during this
subsequent reporting period which require recognition or additional disclosure in these financial statements.

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Note 20—Selected Quarterly Financial Data (Unaudited)

The following tables summarize the unaudited quarterly financial data for the last two fiscal years.

2018

Revenues 

Operating costs and expenses 

(Loss) income before income taxes 

Net income 

Basic earnings per common share

Diluted earnings per common share

Cash dividends declared per common share

2017

Revenues 

Operating costs and expenses 

Income before income taxes 

Net income 

Basic earnings per common share

Diluted earnings per common share

Cash dividends declared per common share

First Quarter 

Second Quarter 

Third Quarter 

Fourth Quarter 

(in thousands, except per share amounts)

$

$

$

$

$

$

$

$

$

$

$

$

$

$

501,810  $

503,681  $

(1,395) $

72  $

0.00  $

0.00  $

503,732  $

471,736  $

33,316  $

25,814  $

0.35  $

0.35  $

506,871  $

475,916  $

32,982  $

26,086  $

0.35  $

0.35  $

496,408 

457,251 

35,007 

31,552 

0.43 

0.42 

0.19250  $

0.19375  $

0.19500  $

0.19625 

404,490  $

373,780  $

32,279  $

22,017  $

0.30  $

0.30  $

470,876  $

439,313  $

33,078  $

22,551  $

0.31  $

0.30  $

491,355  $

459,864  $

32,930  $

23,472  $

0.32  $

0.31  $

499,410 

466,285 

34,678 

20,186 

0.27 

0.27 

0.18750  $

0.18875  $

0.19000  $

0.19125 

62

 
 
Table of Contents

Item 9.     Changes in and Disagreements with   Accountants on Accounting and Financial   Disclosure.

None.

Item 9A. Controls and Procedures.

Evaluation of Disclosure Controls and Procedures

In accordance with Securities Exchange Act Rules 13a-15 and 15a-15, the Company carried out an evaluation, under the supervision and with the participation of
management,  including  the  Company’s  Chief  Executive  Officer  and  Chief  Financial  Officer,  of  the  effectiveness  of  the  Company’s  disclosure  controls  and
procedures  as  of  the  end  of  the  period  covered  by  this  report.  Based  on  that  evaluation,  the  Company’s  Chief  Executive  Officer  and  Chief  Financial  Officer
concluded that the Company’s disclosure controls and procedures were effective as of December 31, 2018.

Design and Evaluation of Internal Control Over Financial Reporting

Pursuant to Section 404 of the Sarbanes-Oxley Act of 2002, the Company included a report of management’s assessment of the design and effectiveness of the
Company’s internal controls over financial reporting as part of this Annual Report on Form 10-K for the fiscal year ended December 31, 2018. Grant Thornton,
LLP, the Company’s independent registered public accounting firm, also audited the Company’s internal control over financial reporting. Management’s report and
the independent registered public accounting firm’s audit report are included in this Annual Report on Form 10-K within Part II, Item 8 under the captions entitled
“Management’s Report on Internal Control Over Financial Reporting” and “Report of Independent Registered Public Accounting Firm”.

Changes in Internal Control over Financial Reporting

There were no changes in the Company’s internal control over financial reporting that occurred during the period covered by this Annual Report on Form 10-K
that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.

Item 9B.     Other Information.

Not applicable.

63

Table of Contents

Item 10.     Directors, Executive Officers and   Corporate Governance.

PART III

The  information  regarding  directors  and  executive  officers  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement  to  be  mailed  to  its
shareholders in connection with its 2019 Annual Meeting of Shareholders and to be filed within 120 days of the close of the year ended December 31, 2018.

Code of Ethics

The Company has adopted a code of ethics that applies to all employees, including executive officers and directors. The code of ethics is publicly available on the
Corporate  Governance  page  of  the  Company’s  website  at    www.hcsg.com
.  If  the  Company  makes  any  amendments  or  grant  any  waivers,  including  implicit
waivers, from a provision of the Company code of ethics that applies to the principal executive officer, principal financial officer, principal accounting officer or
any  person  performing  similar  functions,  the  Company  will  disclose  the  nature  of  the  amendment  or  waiver,  its  effective  date  and  to  whom  it  applies  on  the
Company’s website set forth above or in a report on Form 8-K filed with the Securities and Exchange Commission.

Item 11.     Executive Compensation.

The information regarding executive compensation is incorporated herein by reference to the Company’s definitive proxy statement to be mailed to shareholders in
connection with its 2019 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year ended December 31, 2018.

Item 12.     Security Ownership of Certain   Beneficial Owners and Management and Related   Stockholder Matters.

The information regarding security ownership of certain beneficial owners and management and related stockholder matters is incorporated herein by reference to
the Company’s definitive proxy statement to be mailed to shareholders in connection with its 2019 Annual Meeting of Shareholders and to be filed within 120 days
of the close of the fiscal year ending December 31, 2018.

Item 13.     Certain Relationships and Related   Transactions, and Director Independence.

The information regarding certain relationships and related transactions, and director independence is incorporated herein by reference to the Company’s definitive
proxy statement mailed to shareholders in connection with its 2019 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year
ended December 31, 2018.

Item 14.     Principal Accountant Fees and   Services.

The  information  regarding  principal  accountant  fees  and  services  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement  mailed  to
shareholders in connection with its 2019 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year ended December 31, 2018.

64

Table of Contents

Item 15.     Exhibits and Financial Statement   Schedules.

(a) The following financial statements, schedules and exhibits are filed as part of this report:

PART IV

1 

2 

Index
to
Consolidated
Financial
Statements
— The Financial Statements required by this item are listed on the Index to Financial Statements in Part II,
Item 8 of this report.
Index
to
Financial
Statement
Schedules
—

Schedule II—Valuation and Qualifying Accounts and Reserves; and 

a 
b  Other financial statement schedules are not included because they are not required or the information is otherwise shown in the financial

statements or notes thereto.

3 

Index
to
Exhibits
—

a. The exhibits listed below are filed as part of, or are incorporated by reference into, this report.

(b) See Item 15(a)(3) above.

(c)  See Item 15(a)(2) above.

Item 16.     Form 10-K Summary.

None.

65

Table of Contents

Healthcare Services Group, Inc.
Schedule II — Valuation   and Qualifying Accounts and Reserves

Additions

Description

Beginning Balance 

Charged to Costs and
Expenses

Charged to Other
Accounts

Deductions 

Ending Balance 

2018
Allowance for Doubtful Accounts

2017
Allowance for Doubtful Accounts

2016
Allowance for Doubtful Accounts

$

$

$

(in thousands)

11,985  $

51,387  $

6,911  $

6,250  $

4,608  $

4,629  $

— 

— 

— 

$

$

$

6,163 

1,176 

2,326 

$

$

$

57,209 

11,985 

6,911 

66

Table of Contents

The following Exhibits are filed as part of this Report (references are to Reg. S-K Exhibit Numbers):

Exhibit Index

Incorporated by Reference

Date of Filing

Exhibit Number

Filed Herewith

File No.

0-12015

0-12015

0-12015

3/21/2001

5/24/2007

2/19/2015

2-87625-W

— 

333-92835
0-12015

0-12015

0-12015
0-12015

333-108182
— 
— 
— 

— 

— 

— 

— 

12/15/1999
10/28/2016

10/22/2012

7/27/2012
12/31/2018

8/22/2003
— 
— 
— 

— 

— 

— 

— 

3.2 

3.1 

3.3 

4.1 

4(a)
4.1 

10.1 

10.1 
10.1 

99.0 
— 
— 
— 

— 

— 

— 

— 

— 

— 

— 

— 

— 
— 

— 

— 
— 

— 
X
X
X

X

X

X

X

Exhibit Number Description

3.1 

3.2 

3.3 

4.1 (P) 

4.2†
4.3†

4.5†

10.1† 
10.2 

10.3 
21
23
31.1 

31.2 

32.1 

32.2 

101

 to  the  Amended  and  Restated  Articles  of

Amended  and  Restated  Articles  of  Incorporation  of  the
Registrant as of May 30, 2000
Amendment
Incorporation of the Registrant as of May 22, 2007
Second  Amended  and  Restated  Bylaws  of  the  Registrant  as  of
February 17, 2015
Specimen Certificate of the Common Stock, $.01 par value, of
the Registrant
Healthcare Services Group, Inc. Employee Stock Purchase Plan
Healthcare Services Group, Inc. Amendment No. 3 to Employee
Stock Purchase Plan
Healthcare Services Group, Inc. Amended and Restated Deferred
Compensation Plan
Second Amended and Restated 2012 Equity Incentive Plan
$475,000,000  Revolving  Credit  Facility,  dated  as  of  December
21, 2018
Healthcare Services Group, Inc. Dividend Reinvestment Plan
Subsidiaries of Healthcare Services Group, Inc.
Consent of Independent Registered Public Accounting Firm
Certification  of
 pursuant
Section 302 of the Sarbanes-Oxley Act
Certification  of
Section 302 of the Sarbanes-Oxley Act
Certification  of  the  Principal  Executive  Officer  pursuant  to
Section 906 of the Sarbanes-Oxley Act
Certification  of  the  Principal  Financial  Officer  pursuant  to
Section 906 of the Sarbanes-Oxley Act
The following financial information from the Company's Form
10-K for the fiscal year ended December 31, 2018 were
formatted in iXBRL (Inline eXtensible Business Reporting
Language): (i) Consolidated Balance Sheets, (ii) Consolidated
Statements of Comprehensive Income, (iii) Consolidated
Statements of Cash Flows, (iv) Consolidated Statements of
Stockholders' Equity, and (v) Notes to Consolidated Financial
Statements

 Executive  Officer

 Financial

 Principal

 Principal

 pursuant

 Officer

 to

 to

† 
(P) 

Indicates a management plan or compensatory plan or arrangement.
Prior to digital copy

Form

10-K

8-K

10-K

S-18

S-8
10-Q

10-Q

10-Q
8-K

S-3D
— 
— 
— 

— 

— 

— 

— 

67

Table of Contents

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by
the undersigned, thereunto duly authorized.

Signatures

Dated: March 18, 2019

HEALTHCARE SERVICES GROUP, INC.

(Registrant)

By:

/s/ Theodore Wahl

Theodore Wahl

President and Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons and in the capacities and on the
date indicated:

Signature

Title

Date

/s/ Theodore Wahl

Theodore Wahl

/s/ John C. Shea

John C. Shea

/s/ Jude Visconto

Jude Visconto

Director and President & Chief Executive Officer

March 18, 2019

(Principal Executive Officer)

Chief Financial Officer

(Principal Financial and Accounting Officer)

Chairman of the Board

March 18, 2019

March 18, 2019

/s/ Michael E. McBryan

Director and Executive Vice President & Chief Revenue Officer

March 18, 2019

Michael E. McBryan

/s/ John M. Briggs

John M. Briggs

/s/ Robert L. Frome

Robert L. Frome

/s/ Diane S. Casey

Diane S. Casey

/s/ Robert J. Moss

Robert J. Moss

Director

Director

Director

Director

/s/ Dino D. Ottaviano

Director

Dino D. Ottaviano

/s/ John J. McFadden

Director

John J. McFadden

/s/ Daniela Castagnino

Director

Daniela Castagnino

68

March 18, 2019

March 18, 2019

March 18, 2019

March 18, 2019

March 18, 2019

March 18, 2019

March 18, 2019

SUBSIDIARIES OF HEALTHCARE SERVICES GROUP, INC.
AS OF DECEMBER 31, 2018  

Year Formed
2011

Jurisdiction
Pennsylvania

Description
Staff Leasing offers professional employer organization services to
clients in the healthcare industry.

Exhibit 21

Entity Name

HCSG Staff Leasing Solutions, LLC ("Staff
Leasing")

HCSG Insurance Corp.

HCSG Labor Supply, LLC ("Labor Supply")

HCSG East, LLC

2014

2014

2015

New Jersey

Pennsylvania

New Jersey

HCSG Central, LLC

2015

New Jersey

HCSG West, LLC

2015

New Jersey

HCSG East Labor Supply, LLC

2015

New Jersey

HCSG Clinical Services, LLC

2017

New Jersey

HCSG Insurance Corp. is a captive insurance company which
provides the Company with certain insurance-related services.

Labor Supply offers personnel solutions on an indefinite basis in
specific job classifications to clients in the healthcare industry.

HCSG East, LLC provides housekeeping, laundry and dietary
services at client facilities as a subcontracted service provider on
behalf of HCSG.

HCSG Central, LLC provides housekeeping, laundry and dietary
services at client facilities as a subcontracted service provider on
behalf of HCSG.

HCSG West, LLC provides housekeeping, laundry and dietary
services at client facilities as a subcontracted service provider on
behalf of HCSG.

HCSG East Labor Supply, LLC provides personnel solutions on an
indefinite basis in specific job classifications to clients in the
healthcare industry.

HCSG Clinical Services, LLC provides clinical, nutrition, dietician
and similar services as a subcontracted service provider on behalf
of HCSG.

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We have issued our reports dated March 18, 2019 , with respect to the consolidated financial statements, schedule, and internal control over financial reporting
included  in  the  Annual  Report  of  Healthcare  Services  Group,  Inc.  and  Subsidiaries  on  Form  10-K  for  the  year  ended  December  31, 2018  . We consent to the
incorporation by reference of said reports in the Registration Statements of Healthcare Services Group, Inc. on Forms S-3 (File No. 333-108182, effective August
22, 2003,   and on Forms S-8 (File No. 333-92835, effective December 15, 1999, and File No. 333-184612, effective October 26, 2012).

Exhibit 23

/s/ GRANT THORNTON LLP

New York, New York
March 18, 2019

Exhibit 31.1

Certification of the Chief Executive Officer  
Pursuant to Rules 13a-14(a) and 15d-14(a)  
Under the Securities Exchange Act, as Amended

I, Theodore Wahl, certify that:

1. I have reviewed this Annual Report on Form 10-K of Healthcare Services Group, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements

made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial

condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules  13a-15(e)  and  15d-15(e))  and  internal  control  over  financial  reporting  (as  defined  in  Exchange  Act  Rules  13a-15(f)  and  15d-15(f))  for  the  registrant  and
have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during
the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to
provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance
with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of

the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s fourth fiscal quarter

that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.  The  registrant’s  other  certifying  officer  and  I  have  disclosed,  based  on  our  most  recent  evaluation  of  internal  control  over  financial  reporting,  to  the

registrant’s auditors and the audit committee of the registrant’s Board of Directors:

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to

adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over

financial reporting

Date: March 18, 2019

/s/ Theodore Wahl

Theodore Wahl

President & Chief Executive Officer

(Principal Executive Officer)

Exhibit 31.2

Certification of the Chief Financial Officer  
Pursuant to Rules 13a-14(a) and 15d-14(a)  
Under the Securities Exchange Act, as Amended

I, John C. Shea, certify that:

1. I have reviewed this Annual Report on Form 10-K of Healthcare Services Group, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements

made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial

condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules  13a-15(e)  and  15d-15(e))  and  internal  control  over  financial  reporting  (as  defined  in  Exchange  Act  Rules  13a-15(f)  and  15d-15(f))  for  the  registrant  and
have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during
the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to
provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance
with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of

the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s fourth fiscal quarter

that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.  The  registrant’s  other  certifying  officer  and  I  have  disclosed,  based  on  our  most  recent  evaluation  of  internal  control  over  financial  reporting,  to  the

registrant’s auditors and the audit committee of the registrant’s Board of Directors:

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to

adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over

financial reporting

Date: March 18, 2019

/s/ John C. Shea

John C. Shea

Chief Financial Officer

(Principal Financial and Accounting Officer)

Certification   Pursuant to
18 U.S.C. Section 1350,
As Adopted   Pursuant to
Section 906 of   the Sarbanes-Oxley Act of 2002

Exhibit 32.1

In connection with the Annual Report on Form 10-K of Healthcare Services Group, Inc. (the “Company”) for the year ended December 31, 2018 as filed with the
Securities  and  Exchange  commission  on  the  date  hereof  (the  “Report”),  I,  Theodore  Wahl,  President  and  Chief  Executive  Officer      of  the  Company,  certify,
pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d), of the Securities Exchange Act of 1934; and

(2) That information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date: March 18, 2019

/s/ Theodore Wahl

Theodore Wahl

President & Chief Executive Officer

(Principal Executive Officer)

 
Certification   Pursuant to
18 U.S.C. Section 1350,
As Adopted   Pursuant to
Section 906 of   the Sarbanes-Oxley Act of 2002

Exhibit 32.2

In connection with the Annual Report on Form 10-K of Healthcare Services Group, Inc. (the “Company”) for the year ended December 31, 2018 as filed with the
Securities and Exchange commission on the date hereof (the “Report”), I, John C. Shea, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C.
Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d), of the Securities Exchange Act of 1934; and

(2) That information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date: March 18, 2019

/s/ John C. Shea

John C. Shea

Chief Financial Officer

(Principal Financial and Accounting Officer)