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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FY2020 Annual Report · Healthcare Services Group, Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

Form 10-K
(Mark One)

☑ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE

SECURITIES EXCHANGE ACT OF 1934

For the fiscal year ended December 31, 2020
OR

☐ 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.

(Exact name of registrant as specified in its charter)

Pennsylvania
(State or other jurisdiction of 
incorporation or organization)

3220 Tillman Drive, Suite 300, Bensalem, PA
(Address of principal executive offices)

23-2018365
(I.R.S. Employer Identification No.)

19020
(Zip Code)

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

Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Common Stock, $.01 par value

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

Trading Symbol(s)
HCSG

Name of each exchange on which registered
NASDAQ Global Select Market

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 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 such files). Yes  þ    No  ¨

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 ☐

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. ¨ 

Indicate  by  check  mark  whether  the  registrant  has  filed  a  report  on  the  attestation  to  its  management's  assessment  of  the  effectiveness  of  its  internal  control  over  financial
reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered accounting firm that prepared or issued its audit report. ☑

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,  2020  was
approximately $1.80 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 (February 24,
2021). 74,717,000

 
 
Portions of the definitive  Proxy Statement for the Registrant’s Annual Meeting of Shareholders  to be held on June 1, 2021 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, 2020

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
7
15
15
15
16

17
17
19
30
31
66
66
66

67
67
67
67
67

68
68
70
71

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 to the healthcare industry, primarily providers of long-term care; the impact of and future effects of the COVID-19 pandemic or
other potential pandemics; having a significant portion of our consolidated revenues contributed by one customer during the year ended December 31, 2020; credit
and collection risks associated with the healthcare industry; our claims experience related to workers’ compensation and general liability insurance (including any
litigation  claims,  enforcement  actions,  regulatory  actions  and  investigations  arising  from  personal  injury  and  loss  of  life  related  to  COVID-19);  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;
changes in the federal corporate tax rate; the impact of the Securities and Exchange Commission investigation and related class action lawsuit; risks associated with
the  reorganization  of  our  corporate  structure;  and  the  risk  factors  described  in  Part  I  of  this  report  under  “Government  Regulation  of  Customers,”  “Service
Agreements and Collections,” and “Competition” under Item IA. “Risk Factors.”

These  factors,  in  addition  to  delays  in  payments  from  customers  and/or  customers  in  bankruptcy,  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 and COVID-19) could not be passed on to our
customers.

In  addition,  we  believe  that  to  improve  our  financial  performance  we  must  continue  to  obtain  service  agreements  with  new  customers,  retain  and  provide  new
services  to  existing  customers,  achieve  modest  price  increases  on  current  service  agreements  with  existing  customers  and/or  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 growth strategies.

Table of Contents

In this Annual Report on Form 10-K for the year ended December 31, 2020, 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  Services  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 United States, rendering such services to over 3,000 facilities throughout the continental United
States as of December 31, 2020.

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, 2020, 2019 and 2018.

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 customer facilities and provide Dietary services to over 1,500 facilities. Although we do not directly
participate  in  any  government  reimbursement  programs,  our  customers  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 customers. Under such agreements, we are responsible for the day-to-day management
of the employees located at our customers’ facilities, as well as for the provision of certain supplies. We also provide services on the basis of management-only
agreements for a limited number of customers. Under a management-only agreement, we provide management and supervisory services while the customer facility
retains payroll responsibility for the non-supervisory staff. Our agreements with customers typically provide for a renewable one year service term, cancellable by
either party upon 30 to 90 days’ notice after an initial period of 60 to 120 days.

We typically adopt and follow our customers’ employee wage structures, including policies of wage rate increases, and pass through to the customer 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  50.9%,  or  $895.3  million,  of  our  consolidated  revenues  in  2020.  The  services  provided  under  this  segment  include
managing our customers’ housekeeping departments, which are principally responsible for the cleaning, disinfecting and sanitizing of resident rooms and common
areas of the customers’ facilities, as well as the laundering and processing of the bed linens, uniforms, resident personal clothing and other assorted linen items
utilized  at  the  customers’  facilities.  Upon  beginning  service  with  a  customer  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 customer 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 80.5% of Housekeeping
revenues for 2020. 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 2020, the cost of Housekeeping supplies as a percentage of Housekeeping revenues was 6.9%. 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 49.1%, or $865.0 million, of our consolidated revenues in 2020. Dietary services consist of managing our customers’
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  customers,  which  may  be  provided  as  a  stand-alone
service, or bundled with other dietary department services. Upon beginning service with a customer 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 customer 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
2020, the costs of labor and food-related supplies represented approximately 63.7% and 26.5% of Dietary revenues, respectively.

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Significant Customers

For  the  years  ended  December  31,  2020,  2019  and  2018,  both  the  Housekeeping  and  Dietary  segments  earned  revenue  from  several  significant  customers,
including Genesis Healthcare, Inc. ("Genesis"). For the years ended December 31, 2020, 2019 and 2018, Genesis accounted for $258.7 million or 14.7%, $287.8
million or 15.6% and $386.7 million or 19.3% of the Company's consolidated revenues, respectively.

Operational Management Structure

By applying our professional management techniques, we offer our customers 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, including the compliance and financial performance of the Directors of
Operations they oversee.

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

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.

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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 results, along with continued business development.

Our services are marketed primarily through referrals and solicitation of target facilities. We also participate in industry trade shows, healthcare trade associations
and healthcare support service seminars 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 customer. Once the prospective
customer accepts the proposal and executes our service agreement, we are structured to timely and efficiently establish our operations and systems at the customer
facilities.

Government Regulation of Customers

We  do  not  directly  participate  in  any  government  reimbursement  programs  and  our  contractual  relationships  with  our  customers  determine  their  payment
obligations to us. However, our customers are subject to government regulation and laws which directly affect how they are paid for certain services they provide.
Therefore,  because our customers’ 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 customers’  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 customers’ 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 customer retention rate and expect to continue to maintain satisfactory relationships with our customers, despite many of our
service agreements being cancellable on short notice.

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We have had varying collections experiences with respect to our accounts and notes receivable. We have sometimes extended the period of payment for certain
customers beyond contractual terms. Such customers 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 $9.6 million, $25.5 million and $51.4 million in the years ended December 31, 2020, 2019 and 2018, respectively (see Schedule II -
Valuation and Qualifying Accounts and Reserves for year-end balances). As a percentage of total revenues, these provisions represented approximately 0.5%, 1.4%
and 2.6% for the years ended December 31, 2020, 2019 and 2018, respectively. In addition, the Company recorded a $32.1 million cumulative effect adjustment to
Retained  Earnings  on  January  1,  2020  in  accordance  with  the  Company's  adoption  of  Financial  Accounting  Standards  Board  ("FASB")  Accounting  Standards
Codification subtopic 326 Credit Losses - Measurement of Credit Losses on Financial Instruments ("ASC 326"), which represented 1.7% of consolidated revenues
for the year ended December 31, 2020. In making 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  through  our  payment  terms,  perform
ongoing credit evaluations and monitor accounts to minimize the risk of loss. Despite our efforts to minimize credit risk exposure, customers could be adversely
affected if future industry trends change in such a manner as to negatively impact their cash flows. If our customers experience a negative impact on their cash
flows, it could have a material adverse effect on our results of operations and financial condition.

Competition

We compete primarily with the in-house service departments of our potential customers. In addition, a number of regional and local firms compete with us in the
regional markets in which we conduct business. There are also several national and multinational service firms that provide similar services primarily within non-
healthcare markets, but also within the broader healthcare industry. Historically such firms have not invested significant resources on the long-term, post-acute and
healthcare segments typically serviced by us.

Human Capital Resources

Ensuring a positive social impact is inherent in our mission to deliver exceptional services to an ever-changing healthcare industry. In delivering upon this goal, we
strive for operational excellence while creating a safe working environment, promoting environmental and employee health and safety awareness, and seeking to
continuously create opportunities for professional and career development for our employees. In order to continue to deliver on our strategic focus and Company
Vision - To Be THE Choice For Our Customers - resulting in retention of and growth in relationships through good customer-service, expansion of our services,
effective execution in all that we do, and cost management; it is crucial that we attract and retain talent in the markets that we serve. To facilitate talent attraction
and  retention,  we  strive  to  make  Healthcare  Services  Group,  Inc.  an  inclusive,  safe  and  healthy  workplace,  with  opportunities  for  our  employees  to  grow  and
develop in their careers, supported by competitive compensation, benefits and health and welfare programs.

Supporting our diverse team of individuals drives us to continuously improve and provide developmental opportunities for every team member, encouraging all of
our  employees  to  reach  their  full  potential.  To  support  this  we  have  launched  a  formal  Employee  Engagement  and  Recognition  Program.  We  devise  career
development  and  promotional  pathways  for  all  employees,  with  staunch  commitment  to  promotion  from  within,  and  our  Manager-In-Training  Program  is
accessible for all qualified and motivated employees, regardless of formal education level achieved. We advertise all on-demand opportunities to our employees in
an effort to cultivate talent throughout the Company. We also focus on understanding our diversity and inclusion strengths and opportunities. We continue to focus
on building a pipeline for talent to create more opportunities for workplace diversity and to support greater representation within the Company. Some highlights:

•
•
•
•
•

Documented annual and ongoing training for employees at all levels on diversity and inclusion;
Celebrating and creating diversity among our teams;
Our workforce consists of 71% females and 64% minorities;
Among field-based management positions, 74% are women and 49% are minorities; and
Among our top quartile of compensation for employees, 62% are women and 57% are minorities.

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Employee Profile

At  December  31,  2020,  we  employed  approximately  44,200  people,  of  whom  approximately  5,300  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  customer  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 customer facilities and their employee unions, or between us and such unions. We consider our relationship with our employees to be good.

Health and Safety

Our ability to meet the day-to-day needs and expectations of our customers and to fulfill our common goal to ensure the well-being of America’s most vulnerable is
organically connected to the well-being of our people. As such, we are committed to the health, safety and wellness of our employees. We provide our employees
and their families access to a variety of flexible and convenient health and welfare programs, including benefits that support their physical and mental health by
providing tools and resources to help them improve or maintain their health status; and that offer choice where possible so they can customize their benefits to meet
their needs and the needs of their families. In response to the COVID-19 pandemic, we implemented significant operating environment changes that we determined
were in the best interest of our employees, as well as the communities in which we operate, and which comply with government regulations. This includes having
the  vast  majority  of  our  corporate  and  field  management  personnel  work  from  home,  while  implementing  additional  safety  measures  for  employees  continuing
critical on-site work. All employees receive documented, annual training on our Environmental, Health and Safety Policy and are responsible for upholding and
operating within the guidelines of this policy to ensure our business complies with all environmental and health and safety laws and regulations applicable to our
operations.

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 Commission’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.

Risks Related to Macroeconomic Conditions

COVID-19 and other pandemics, epidemics, or outbreaks of a contagious illness may adversely affect our operating results, cash flows and financial condition.

While  the  COVID-19  pandemic  did  not  have  a  material  net  impact  on  our  consolidated  operating  results  for  the  year  ended  December  31,  2020,  additional
coronavirus  outbreaks  and  other  pandemics,  epidemics,  or  outbreaks  of  a  contagious  illness,  and  similar  events,  may  cause  harm  to  us,  our  employees,  our
customers,  our  vendors  and  supply  chain  partners,  and  financial  institutions,  which  could  have  a  material  adverse  effect  on  our  results  of  operations,  financial
condition and cash flows. The impacts may include, but would not be limited to:

•

•

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Decreased availability and/or increased cost of supplies due to increased demand around essential cleaning supplies including disinfecting agents, personal
protective equipment (“PPE”), and food and food-related products due to increased global demand and disruptions along the global supply chains of these
manufactures and distributors;
Disruption  to  operations  due  to  the  unavailability  of  employees  due  to  illness,  quarantines,  risk  of  illness,  travel  restrictions  or  factors  that  limit  our
existing or potential workforce;
Limitations to the availability of our key personnel due to travel restrictions and access restrictions to our customers' facilities;
Our ability to meet more stringent, medically-required procedures, and infection control requirements at customer facilities;
Elevated employee turnover which may impact our facility level performance and/or increase payroll expense and recruiting-related expenses;
Decreased census in the nursing home and long-term care industry, which could impact the financial health of our customers and thereby increasing our
associated credit risk with customers and increased pressures to modify our contractual terms; and
Significant disruption of global financial markets, which could negatively impact us or our customers’ ability to access capital in the future.

In  addition,  we  have  taken  and  will  continue  to  take  temporary  precautionary  measures  intended  to  help  minimize  the  risk  of  COVID-19  to  our  employees,
including requiring administrative and other groups of our employees to work remotely, restricting non-essential travel and attendance at industry events and in-
person work-related meetings.

The further spread of COVID-19, and the requirements to take action to help limit the spread of the virus, could impact the resources required to carry out our
business as usual and may have a material  adverse  effect  on our results of operations,  financial  condition  and cash flows. The extent  to which COVID-19 will
impact our business and our financial results will depend on future developments, which are highly uncertain and cannot be predicted. Such developments may
include the ongoing geographic spread of the virus, the severity of the disease, the duration of the outbreak and the type and duration of actions that may be taken
by  various  governmental  authorities  in  response  to  the  outbreak  and  the  impact  on  the  United  States  and  the  global  economy.  Any  of  these  developments,
individually or in aggregate, could materially impact our business and our financial results and condition.

We  may  incur  additional  liabilities  in  our  Paid  Loss  Retrospective  Insurance  Plan  for  general  liability  and  workers’  compensation  insurance  related  to
COVID-19 which may adversely affect our operating results, cash flows and financial condition.

As a result of the impact of COVID-19, litigation claims, enforcement actions, regulatory actions and investigations arising from personal injury and loss of life,
have been and may, in the future, be asserted against us. 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

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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.  We  expect  many  of  these  claims  and  actions,  or  any  settlement  of  these  claims  and  actions,  to  be  covered  by  insurance  and  historically  the  maximum
amount of our liability, net of any insurance recoverables, has been limited to our self-insurance retention levels.

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 a substantial portion of 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 customers such increased costs but sometimes we are unable to do so. Even when we are
able to pass on such costs to our customers, 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 customers. It is this type of spike and unanticipated increase in Dietary supplies costs
that  could  adversely  affect  Dietary’s  operating  performance.  The  adverse  effect  would  be  realized  if  we  delay  in  passing  on  such  costs  to  our  customers  or  in
instances where we may not be able to pass such increase on to our customers 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 customers,
our delay in, or inability to pass such wage increases through to our customers could have a material adverse effect on our financial condition, results of operations,
and cash flows.

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.

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.

The historical performance of our common stock, $0.01 par value (the "Common Stock"), reflects high market expectations for our future operating results. Our
business  strategy  focuses  on  growth  and  improving  profitability  through  obtaining  service  agreements  with  new  customers,  providing  new  services  to  existing
customers,  obtaining  modest  price  increases  on  service  agreements  with  customers  and  maintaining  internal  cost  reduction  strategies  at  our  various  operational
levels. If we are unable to continue either historical customer 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.

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Risks Related to Customers and Distributors

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

Genesis contributed 14.7%, 15.6% and 19.3% of our total consolidated revenues for the years ended December 31, 2020, 2019 and 2018, respectively. On August
10, 2020 as part of Genesis' earnings release, Genesis disclosed significant doubt about its ability to continue as a going concern. Since such announcement, the
Company's collection activity from Genesis has been largely unaffected with the Company closely monitoring such Genesis accounts. As of December 31, 2020,
the  Company  had  outstanding  accounts  receivable  and  notes  receivable  of  $22.5  million  and  $21.3  million,  respectively,  from  Genesis.  Although  we  expect  to
continue the relationship with Genesis, there can be no assurance thereof. The loss of Genesis as a customer, or a significant reduction in the revenues we receive
from Genesis, could have a material adverse effect on the results of operations of our two operating segments and the Company. In addition, if Genesis fails to
abide  by  current  payment  terms  it  could  increase  our  accounts  receivable  balance  and  have  a  material  adverse  effect  on  our  financial  condition,  results  of
operations, and cash flows.

Our  customers  are  concentrated  in  the  healthcare  industry,  which  is  subject  to  changes  in  government  regulation.  Many  of  our  customers  rely  on
reimbursement from Medicare, Medicaid and other third-party payors. Rates from such payors may be altered or reduced, thus affecting our customers’ 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 customers’ 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
customers’  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  customers’  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 customers have resulted in, and could continue to result in,
significant additional bad debts.

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,  COVID-19's  impact  on  census  and  operating  costs,  customers’
dependence on continued Medicare and Medicaid funding and the impact of additional regulatory actions and/or insufficient funding.

We have sometimes extended the period of payment for certain customers beyond contractual terms. Such customers 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 $9.6 million for the year ended December 31, 2020 as compared to
$25.5 million and $51.4 million for the years ended December 31, 2019 and 2018, respectively. In addition, the Company recorded a $32.1 million cumulative
effect adjustment to Retained Earnings on January 1, 2020 in accordance with the Company's adoption of FASB ASC 326, which represented 1.7% of consolidated
revenues  for  the  year  ended  December  31,  2020.  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  through  our  payment
terms, perform ongoing credit evaluations and monitor accounts to minimize the risk of loss. Despite our efforts to minimize credit risk exposure, customers could
be adversely affected if future industry trends change in such a manner as to negatively impact their cash flows. If our customers experience a negative impact on
their cash flows, it could have a material adverse effect on our financial condition, results of operations, and cash flows.

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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  customers,  and  potential  customers,  is  impacted  by  their  ability  to  maintain  positive  relationships  with  their  respective
landlords.  Any  loss  or  deterioration  in  the  relationship  between  our  customers  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  customers  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 customers may lose their ability to continue conducting
operations and as a result terminate their service agreements with us.

In fiscal 2020, one distributor distributed approximately 50% of our food and non-food dining supplies, and if our relationship or their business were to be
disrupted, we could experience disruptions to our operations and cost structure.

Although we negotiate the pricing and other terms for the majority of our purchases of food and dining supplies directly with national manufacturers, we procure
these products and other items through Sysco Corporation ("Sysco"). Sysco, is responsible for tracking our orders and delivering products to our specific locations.
If our relationship with, or the business of, Sysco were to be disrupted, we would have to arrange alternative distributors and our operations and cost structure could
be adversely affected in the short term.

Risks Related to Our Operating Our Business

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.

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 typically do not enter into long-term contractual agreements with our customers for the rendering of our services. Our agreements with customers typically
provide for a renewable one year service term, cancellable by either party upon 30 to 90 days’ notice after an initial period of 60 to 120 days. Consequently, our
customers can often unilaterally decrease the amount of services we provide or terminate all services pursuant to the terms of our service agreements. Although we
have historically had a favorable customer retention rate and expect to continue to maintain satisfactory relationships with our customers, in the event the Company
were to lose a significant number of customers, such loss 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 customers and obtaining new customers.

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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. Products we purchase and utilize in production 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 customer 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.

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 a control deficiency 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 the payment of a dividend, could cause our stock price to decline.

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Our business could be negatively affected as a result of actions of activist shareholders, and such activism could impact the trading value of our securities.

Shareholders may, from time to time, engage in proxy solicitations or advance shareholder proposals, or otherwise attempt to effect changes and assert influence on
our board of directors and management. Activist campaigns that contest or conflict with our strategic direction or seek changes in the composition of our board of
directors could have an adverse effect on our operating results and financial condition. A proxy contest would require us to incur significant legal and advisory
fees,  proxy  solicitation  expenses  and  administrative  and  associated  costs  and  require  significant  time  and  attention  by  our  board  of  directors  and  management,
diverting their attention from the pursuit of our business strategy. Any perceived uncertainties as to our future direction and control, our ability to execute on our
strategy, or changes to the composition of our board of directors or senior management team arising from a proxy contest could lead to the perception of a change
in  the  direction  of  our  business  or  instability  which  may  result  in  the  loss  of  potential  business  opportunities,  make  it  more  difficult  to  pursue  our  strategic
initiatives, or limit our ability to attract and retain qualified personnel and business partners, any of which could adversely affect our business and operating results.
If  individuals  are  ultimately  elected  to  our  board  of  directors  with  a  specific  agenda,  it  may  adversely  affect  our  ability  to  effectively  implement  our  business
strategy and create additional value for our shareholders. We may choose to initiate, or may become subject to, litigation as a result of a proxy contest or matters
arising  from  a  proxy  contest,  which  would  serve  as  a  further  distraction  to  our  board  of  directors  and  management  and  would  require  us  to  incur  significant
additional  costs.  In  addition,  actions  such  as  those  described  above  could  cause  significant  fluctuations  in  our  stock  price  based  upon  temporary  or  speculative
market perceptions or other factors that do not necessarily reflect the underlying fundamentals and prospects of our business.

Risks Related to Governmental and Regulatory Changes

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

Continued  changes  to  the  health  insurance  industry  and  its  obligations  on  employers  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 customers 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.

States in which our customers are located could experience significant budget deficits and such deficits may result in reduction of reimbursements to nursing
homes.

States in which our customers are located could have 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 revise reimbursement structures for nursing home
services.  Any disruption  or  delay  in  the  distribution  of  Medicaid  and  related  payments  to  our  customers  will  adversely  affect  their  cash  flows  and  impact  their
ability to pay us as agreed upon for the services provided.

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 through cost increases we incur to our customers due to regulatory changes, our delay in, or inability to pass
such costs through to our customers, could have a material adverse effect on our financial condition, results of operations and cash flows.

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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, reimbursements, or injunctions. Also, our customers’ 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 customers
being fined and seeking recovery from us, which could also adversely impact our financial condition, results of operations, and cash flows.

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,  but  such  estimates  assume  no  changes  in  current  tax  rates.  In  addition,  if  the  Internal  Revenue  Service  or  other  taxing
authority disagrees on a tax position we have 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 financial condition, results of operations, 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 customers 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.

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.

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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 and prior to the filing of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.

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.  The  ongoing  SEC  investigation  and/or  any  related  litigation  could  adversely  affect  or  cause  variability  in  our  financial
results.

On  March  22,  2019,  a  putative  shareholder  class  action  lawsuit  alleging  violations  of  the  federal  securities  laws  was  filed  against  the  Company  and  our  Chief
Executive  Officer  in  the  U.S.  District  Court  for  the  Eastern  District  of  Pennsylvania  in  connection  with  the  matters  related  to  the  SEC  investigation.  The  class
action  complaint  was  amended  on  September  17,  2019.  Please  refer  to  “Item  3.  Legal  Proceedings”  and  “Note  17—Other  Contingencies  ”  to  the  consolidated
financial statements included in this Form 10-K for more information. We cannot predict the outcome of the lawsuit, the magnitude of any potential losses or the
effect such litigation may have on us or our operations. Regardless of the outcome, lawsuits and investigations involving us, or our current or former officers and
directors,  could  result  in  significant  expenses  and  divert  attention  and  resources  of  our  management  and  other  key  employees.  We  could  be  required  to  pay
damages  or  other  penalties  or  have  injunctions  or  other  equitable  remedies  imposed  against  us  or  our  current  or  former  directors  and  officers  including  any
obligation to indemnify our current and former directors and officers in connection with lawsuits, governmental investigations and related litigation or settlement
amounts.  Such  amounts  could  exceed  the  coverage  provided  under  our  insurance  policies.  Any  of  these  factors  could  harm  our  reputation,  business,  financial
condition, results of operations or cash flows. In addition, the Company may be subject to further litigation from third parties related to the matters under review by
the SEC.

Our business and financial results could be adversely affected by unfavorable results of material litigation or governmental inquiries.

In addition  to the SEC investigation  and class  action  lawsuit,  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 customers, 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.

Risks Related to Cybersecurity and Data Privacy

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 financial condition, results of operations, and liquidity.

14

Table of Contents

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, Texas, Florida 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 customers’ 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 customer facilities where we provide services under a full service
housekeeping  agreement.  Generally,  the  aggregate  cost  of  housekeeping  equipment  located  at  each  customer  facility  is  approximately  $4,000. Additionally,  we
have  laundry  installations  at  certain  customer  facilities.  We  believe  that  such  laundry  equipment,  office  furniture  and  equipment,  housekeeping  equipment  and
vehicles are sufficient to support our current operations.

Item 3.   Legal Proceedings.

In the normal course of business, the Company is involved in various administrative and legal proceedings, including labor and employment, contracts, personal
injury, and insurance matters.

As previously disclosed, the SEC is conducting an investigation into our EPS calculation practices. Following receipt of a letter from the SEC in November 2017
regarding its inquiry into those practices followed by a subpoena in March 2018, we authorized our outside counsel to conduct an internal investigation, under the
direction  of  the  Company’s  Audit  Committee,  into  matters  related  to  the  SEC  subpoena.  This  investigation  was  completed  in  March  2019  and  we  continue  to
cooperate with the SEC’s investigation and document requests.

The Company and the SEC have recently commenced discussions regarding a potential resolution of the investigation, which focuses on periods prior to 2018. As
discussions regarding a potential resolution with the SEC are ongoing, Mr. John C. Shea, the Company’s Chief Financial Officer, has notified the Company that he
is taking a temporary leave of absence from his duties, with effect from February 9, 2021. On February 9, 2021, the Board of Directors of the Company appointed
Mr.  Andrew  Brophy  as  the  Company’s  Acting  Principal  Accounting  Officer  with  immediate  effect.  Mr.  Brophy  has  served  as  the  Company’s  Director  of
Accounting since November 2020 and SEC Reporting Manager since January 2018.

On March 22, 2019, a putative shareholder class action lawsuit was filed against the Company and our Chief Executive Officer in the U.S. District Court for the
Eastern District of Pennsylvania. The initial complaint, which was filed by a plaintiff purportedly on behalf of all purchasers of our securities between April 11,
2017 and March 4, 2019, alleges violations of the federal securities laws in connection with the matters related to our EPS calculation practices. On September 17,
2019, the complaint  was amended to, among other things,  extend the Class Period to cover the period between April 8, 2014 and March 4, 2019, and to name
additional individuals affiliated with the Company as defendants. The lead plaintiff seeks unspecified monetary damages and other relief on behalf of the plaintiff
class.

While  the  Company  is  vigorously  defending  against  all  litigation  claims  asserted,  this  litigation—along  with  the  ongoing  SEC  investigation—could  result  in
substantial  costs  to  the  Company  and  a  diversion  of  the  Company’s  management’s  attention  and  resources,  which  could  harm  its  business.  In  addition,  the
uncertainty of the pending lawsuit or potential filing of additional lawsuits could lead to more volatility and a reduction in the Company’s stock price. At this time
the Company is unable to reasonably estimate possible losses or form a judgment that an unfavorable outcome is either probable or remote.

In light of the uncertainties involved in such proceedings, the ultimate outcome of a particular matter could become material to the Company’s results of operations
for a particular period depending on, among other factors, the size of the loss or liability imposed and the level of the Company’s operating income for that period.

15

Table of Contents

Item 4.   Mine Safety Disclosures.

Not applicable.

16

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 is traded under the symbol “HCSG” on the NASDAQ Global Select Market. As of February 24, 2021, there were approximately
74.7 million shares of our Common Stock outstanding.

Holders

As  of  February  24,  2021,  we  had  approximately  405  holders  of  record  of  our  Common  Stock.  This  does  not  include  persons  who  hold  our  Common  Stock  in
nominee or “street name” accounts through brokers or banks.

Securities Authorized for Issuance Under Equity Compensation Plans

The  following  table  sets  forth  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, 2020.

Plan Category

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

Weighted-Average Exercise
Price of Outstanding Options,
Warrants and Rights
(in thousands, except per share amounts)

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

Equity compensation plans approved by security holders

Total

2,098  1 $
$
2,098 

33.35 
33.35 

2

4,920 
4,920 

1.

2.

Represents shares of Common Stock issuable upon exercise of outstanding stock awards granted under the 2020 Omnibus Incentive Plan ("the 2020 Plan") and carryover
shares from pre-existing equity plans.
Includes stock awards to purchase 2.5 million shares available for future grant under the 2020 Plan, 2.1 million shares available for issuance under the Company’s 1999
Employee  Stock  Purchase  Plan  as  amended  (the  “1999  Plan”)  and  0.3  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 Deferred Compensation Plan.

17

Table of Contents

Performance Graph

The following graph matches the Company’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, 2015 to December  31, 2020. 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
customer 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.

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, 2015 in stock or index, including reinvestment of dividends.
Fiscal year ending December 31.

Copyright© 2021 Standard & Poor’s, a division of S&P Global. All rights reserved.
Copyright© 2021 Russell Investment Group. All rights reserved.

Company / Index
Healthcare Services Group, Inc.
S&P 500
Russell 2000
NASDAQ Composite

2015

2016

2017

2018

2019

2020

$
$
$
$

100.00  $
100.00  $
100.00  $
100.00  $

114.57  $
111.96  $
121.31  $
108.87  $

156.70  $
136.40  $
139.08  $
141.13  $

121.61  $
130.42  $
123.76  $
137.12  $

75.71  $
171.49  $
155.35  $
187.44  $

90.51 
203.04 
186.36 
271.64 

December 31,

18

Table of Contents

Unregistered Sales of Equity Securities and Use of Proceeds

None.

Item 6.   Selected Financial Data.

Reserved.

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, “2020” refers to the year ended December 31, 2020, and “2019” refers to the year ended December 31,
2019. Discussions of 2018 items and year-to-year comparisons between 2019 and 2018 that are not included in this Form 10-K can be found in “Management’s
Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations”  in  Part  II,  Item  7  of  our  Annual  Report  on  Form  10-K  for  the  fiscal  year  ended
December 31, 2019.

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 when 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 consolidated financial statements as of December 31, 2020 and for the year then ended and the notes accompanying those financial
statements.

COVID-19 Considerations

The Company’s priorities during the COVID-19 pandemic are protecting the health and safety of our employees; maximizing the impact of our main services in
helping customers with the housekeeping and dietary services needs of their facilities, and deploying the talents of our employees and our resources to help the
communities we serve meet and overcome the current challenges. During the year ended December 31, 2020, the COVID-19 pandemic did not have a material net
impact  on  our  consolidated  operating  results.  Revenues  for  the  year  ended  December  31,  2020  included  $32.3  million  of  COVID-19  supplemental  billings,
primarily related to employee pay premiums passed through to customers, which were offset by temporary decreases in recurring billings as a result of census-
driven cost reductions in staffing and purchasing. In the future, the pandemic may cause reduced demand for our services if, for example, the pandemic results in a
recessionary economic environment to the long-term care and skilled nursing industries in which we serve; however since the services that we offer are essential to
our customers, we believe that over the long term, there will continue to be strong demand for our services.

Our ability to operate without significant negative operational impact from the COVID-19 pandemic will in part depend on our ability to protect our employees and
our supply chain. The Company has endeavored to follow the recommended actions of government and health authorities to protect our employees, with particular
measures in place for those working in our customer facilities. For the year ended December 31, 2020, we maintained the consistency of our operations during the
onset of the COVID-19 pandemic. We will continue to innovate in managing our business, coordinating with nursing departments to do our part in the infection
prevention and control continuum and remain flexible in responding to our customer-partners. However, the continued uncertainty resulting from the pandemic and
the effect of the vaccine could result in an unforeseen disruption to our workforce and supply chain (for example an inability of a key supplier or transportation
supplier to source and transport materials) that could negatively impact our operations.

Through December 31, 2020, we continue to generate operating cash flows to meet our short-term liquidity needs, and we expect to maintain access to the capital
markets. In addition, our liquidity and operating cash flows have been favorably impacted by $46.6 million of deferred payroll taxes under the Coronavirus Aid,
Relief, and Economic Security Act (the "CARES Act") which are payable over two equal installments in December 2021 and 2022. We have also not observed any
material impairments of our assets or a significant change in the fair value of our assets due to the COVID-19 pandemic.

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Table of Contents

For additional information on risk factors related to the pandemic or other risks that could impact our results, please refer to “Risk Factors” in Part I, Item 1A of
this Form 10-K.

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 United States, rendering such services to
over 3,000 facilities throughout the continental United States as of December 31, 2020.

We provide services primarily pursuant to full service agreements with our customers. Under such agreements, we are responsible for the day-to-day management
of the employees located at our customers’ facilities, as well as for the provision of certain supplies. We also provide services on the basis of management-only
agreements for a limited number of customers. Under a management-only agreement, we provide management and supervisory services while the customer facility
retains payroll responsibility for the non-supervisory staff. Our agreements with customers typically provide for a renewable one year service term, cancellable 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 customers’ housekeeping departments, which are principally responsible for the cleaning, disinfecting and sanitizing of
resident rooms and common areas of the customers’ facilities, as well as the laundering and processing of the bed linens, uniforms, resident personal clothing and
other assorted linen items utilized at the customers’ facilities. Upon beginning service with a customer 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  customer  requests.  Such  management  personnel  also  oversee  the  execution  of  various  cost and  quality  control  procedures
including continuous training and employee evaluation.

Dietary  consists  of  managing  our  customers’  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
customers, which may be provided as a stand-alone service, or bundled with other dietary department services. Upon beginning service with a customer 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 customer requests. Such management personnel also oversee the execution of
various cost and quality control procedures including continuous training and employee evaluation.

At December 31, 2020, Housekeeping services were provided at essentially all of our approximately 3,000 customer facilities, generating approximately 50.9% or
$895.3 million of our total revenues for the year ended December 31, 2020. Dietary services were provided to over 1,500 customer facilities at December 31, 2020
and contributed approximately 49.1% or $865.0 million of our total revenues for the year ended December 31, 2020.

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 customer-service management and administrative support services to such entities.

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Table of Contents

Our  ability  to  acquire  new  customers,  retain  existing  customers  and  increase  revenues  are  affected  by  many  factors.  Competitive  factors  consist  primarily  of
competing with potential customers’ use of in-house support staff, as well as local or regional companies providing services similar to ours. We believe the primary
revenue  drivers  of  our  business  are  our  ability  to  obtain  new  customers  and  to  provide  additional  services  to  existing  customers.  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 customers to attain desired profit margins at the facility level. The primary economic factor in acquiring new customers is our ability to demonstrate
the cost-effectiveness of our services, because many of our customers’ revenues are generally highly reliant on Medicare and Medicaid reimbursements. Therefore,
our customers’ 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 customers 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  customers  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 customers and increasing revenues.

When evaluating financial performance, we consider the ratio of certain financial items to consolidated revenues. The table below summarizes those metrics for
2020, 2019 and 2018: 

Revenues
Operating costs and expenses:
Costs of services provided

Selling, general and administrative expense excluding change in deferred compensation
liability
Gain on deferred compensation plan investments

Selling, general and administrative expense

Other income (expense):

Investment and other income, net
Interest expense

Income before income taxes
Income taxes
Net income

Relation to Consolidated Revenues
Year Ended December 31,
2019

2018

2020

100.0 %

100.0 %

100.0 %

84.8 %

8.0 %
0.6 %
8.6 %

0.8 %
(0.1)%
7.3 %
1.7 %
5.6 %

87.6 %

7.8 %
0.4 %
8.2 %

0.6 %
(0.2)%
4.6 %
1.1 %
3.5 %

88.3 %

6.9 %
(0.1)%
6.8 %

0.3 %
(0.2)%
5.0 %
0.8 %
4.2 %

Our costs of services can vary and may impact our operating performance. Management reviews two primary 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  80.5%  of  Housekeeping  revenues  in  2020.  Dietary  labor  costs
accounted for approximately 63.7% of Dietary revenues in 2020. 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 6.9% of Housekeeping revenues in 2020. In contrast, supplies consumed in performing our Dietary services
accounted  for  approximately  26.5%  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 customers are concentrated in the healthcare industry and are primarily providers of long-term care. Many of our customers’ 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 customers’ 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 customers’ cash flows and solvency, while the opportunities are related to our ability to offer our
customers cost stability and efficiencies.

21

Years Ended December 31, 2020 and 2019

The following table summarizes the income statement key components that we use to evaluate our financial performance on a consolidated and reportable segment
basis,  for  the  years  ended  December  31,  2020  and  2019.  The  differences  between  the  reportable  segments’  operating  results  and  other  disclosed  data  and  our
consolidated financial results 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

Investment and other income, net

Corporate

Interest expense
Corporate

Income (loss) before income taxes

Housekeeping
Dietary
Corporate and eliminations

Consolidated

Income taxes
Corporate

Revenues

Consolidated

2020

2019

% Change

Year Ended December 31,

(in thousands)

895,267  $
865,036 
1,760,303  $

799,544  $
796,743 
(103,970)
1,492,317  $

909,499 
931,279 
1,840,778 

815,326 
888,010 
(90,459)
1,612,877 

150,778  $

150,022 

13,352  $

10,676 

(1.6)%
(7.1)%
(4.4)%

(1.9)%
(10.3)%
14.9 %
(7.5)%

0.5 %

25.1 %

(1,374) $

(3,459)

(60.3)%

95,723  $
68,293 
(34,830)
129,186  $

94,173 
43,269 
(52,346)
85,096 

1.6 %
57.8 %
(33.5)%
51.8 %

30,504  $

20,515 

48.7 %

$

$

$

$

$

$

$

$

$

$

Consolidated revenues decreased 4.4% to $1.8 billion for the year ended December 31, 2020 compared to the corresponding period in 2019 as a result of the factors
discussed below under Reportable Segments.

22

Reportable Segments

Housekeeping and Dietary revenues decreased 1.6% and 7.1%, respectively, during the year ended December 31, 2020 compared to the corresponding period in
2019. The reductions in revenue were primarily driven by the termination of several customers due to the Company exiting facilities in conjunction with operator
transitions where we have been unable to come to agreeable terms, typically including accelerated payment and stricter credit terms with new operators. Revenue
for the year ended December 31, 2020 included $32.3 million of COVID-19 supplemental billings, primarily related to employee pay premiums passed through to
customers, offset by temporary decreases in recurring billings as a result of census-driven cost reductions in staffing and purchasing. The full impact that COVID-
19 will have on our future revenues is not yet known at this time.

Costs of services provided

Consolidated

Consolidated costs of services provided decreased 7.5% to $1.5 billion for the year ended December 31, 2020 compared to the corresponding period in 2019.

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

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

2020
0.5%
1.9%

Year Ended December 31,
2019
1.4%
2.7%

Change
(0.9)%
(0.8)%

The  decrease  in  the  bad  debt  provision  is  related  to  our  current  assessment  of  the  collectability  of  our  accounts  and  notes  receivable  during  the  year  ended
December 31, 2020. Additionally, we incurred higher than normal bad debt expense during the year ended December 31, 2019 due to the out-of-court restructuring
of a privately held Northeast based operator. Effective January 1, 2020, the Company adopted a new accounting pronouncement which changed the Company’s
procedures for estimating its bad debt provision. Under the new guidance, the Company now records a provision for bad debt based on management’s forecast of
expected future credit losses versus the previous impaired loss model. Refer to the Note 1 — Description of Business and Significant Accounting Policies herein
for additional information on our adoption of the new accounting standard including our day one adjustment. The decline in our self-insurance costs as a percentage
of consolidated revenue was primarily impacted by a favorable $14.0 million adjustment to the Company's self-insurance reserves during 2020 after considering
our updated actuarial estimates for projected incurred losses on past claims as compared to the $2.1 million favorable adjustment recorded in 2019.

Reportable Segments

Costs of services provided for Housekeeping, as a percentage of Housekeeping revenues, decreased to 89.3% for the year ended December 31, 2020 from 89.6% in
the corresponding period in 2019. Costs of services provided for Dietary, as a percentage of Dietary revenues, decreased to 92.1% for the year ended December 31,
2020 from 95.4% in the corresponding period in 2019.

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

2020
80.5%
6.9%
63.7%
26.5%

Year Ended December 31,
2019
80.2%
7.4%
63.6%
29.3%

Change
0.3%
(0.5)%
0.1%
(2.8)%

Variations within these key indicators relate to the provision of services at new facilities and changes in the mix of customers for whom we provide supplies or do
not provide supplies. Management focuses on building efficiencies and managing labor and other costs at the facility level, as well as managing supply chain costs,
for new and existing facilities. The decline in

23

dietary supplies spend as a percentage of dietary revenues was driven by the mix of business where we no longer provide all dining department supplies, declining
census as well as management of food-spend costs.

Consolidated Selling, General and Administrative Expense

Included in selling, general and administrative expense are gains and losses associated with changes in the value of investments under our deferred compensation
liability. These investments represent the amounts held on behalf of the participating employees as changes in the value of these investments affect the amount of
our deferred compensation liability. Gains on the plan investments during the years ended December 31, 2020 and 2019 increased our total selling, general and
administrative expense for these periods. During the year ended December 31, 2020, we incurred an increase to certain costs related to COVID-19, however such
costs were immaterial. There is a possibility for additional increased selling, general and administrative expense related to the pandemic.

Excluding the change in the deferred compensation plan described above, consolidated selling, general and administrative expense decreased $1.1 million or 0.8%
for the year ended December 31, 2020 compared to the corresponding period in 2019. The decrease was primarily a result of higher legal and other professional
fees  incurred  during  2019  in  connection  with  the  Company's  internal  investigation  related  to  the  SEC's  inquiry  regarding  the  Company's  earnings  per  share
calculation practices, along with a reduction in travel related expense.

The table below summarizes the changes in these components of selling, general and administrative expense:

Selling, general and administrative expense excluding change in
deferred compensation liability
Gain on deferred compensation plan investments
Selling, general and administrative expense

$

$

141,578  $
9,200 
150,778  $

142,669  $
7,353 
150,022  $

(1,091)
1,847 
756 

(0.8)%
25.1 %
0.5 %

Year Ended December 31,

2020

2019
(dollar amounts in thousands)

$ Change

% Change

Consolidated Investment and Interest Income, net

Investment and other income increased 25.1% to $13.4 million for the year ended December 31, 2020 compared to the corresponding 2019 period, primarily due
to market fluctuations in the value of our trading security investments representing the funding for our deferred compensation plan.

Consolidated Interest Expense

Consolidated interest expense decreased 60.3% to $1.4 million for the year ended December 31, 2020 compared to the corresponding 2019 period due to strong
cash flows from operations which necessitated fewer interquarter borrowings. Cash flows from operations increased 132% to $217.2 million for the year ended
December  31,  2020  primarily  driven  by  a  $46.6  million  increase  related  to  the  deferral  of  payroll  taxes  under  the  CARES  Act  and  a  $75.7  million  increase  in
collections on outstanding accounts and notes receivable as compared to the year ended December 31, 2019.

Consolidated Income Taxes

Our effective tax rate was 23.6% for the year ended December 31, 2020 compared to 24.1% in 2019.

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Table of Contents

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  at  the  origination  of  an  account  or  note  receivable  in  accordance  with  the  Financial
Accounting Standards Board ("FASB") Accounting Standards Codification subtopic 326 Credit Losses - Measurement of Credit Losses on Financial Instruments
("ASC 326"). ASC 326 was adopted by the Company prospectively as of January 1, 2020.

In adopting  ASC 326, the Company replaced  its previous incurred  loss impairment  model  for estimating  credit  losses on accounts  and notes receivables  for its
reporting of quarterly and annual financial results with an expected loss model prepared in accordance with ASC 326. While the incurred loss impairment model
had the Company recognize credit losses when it was probable that a loss had been incurred, ASC 326 requires the Company to estimate the lifetime expected
credit losses on such instruments and to record an allowance to offset the receivables. Accordingly, credit losses under ASC 326 are generally recognized earlier in
the life cycle of a receivable than under the Company's previous incurred loss model.

The  Allowance  is  evaluated  quarterly  based  upon  our  financial  models  which  consider  historical  collections  experience,  current  market  conditions,  government
funding of Medicare and Medicaid, and reasonable and supportable economic forecasts to estimate lifetime expected credit losses. Portions of the Allowance are
inherently  more  sensitive  to  fluctuations  in  management's  assumptions  than  others,  particularly  any  adjustments  made  to  reflect  reasonable  and  supportable
economic  forecasts.  Such  qualitative  assessments  would  be  expected  to  have  a  greater  effect  on  aged  accounts  receivable  and  notes  receivable  as  compared  to
current  receivables.  Due  to  the  prospective  nature  of  the  Allowance  under  ASC  326,  Management  continues  to  review  our  portfolio  of  accounts  and  notes
receivable and any estimate of credit losses is inherently subjective as it requires estimates that are susceptible to significant revision as more information becomes
available.

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
customers beyond contractual terms. Such customers 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 through our payment terms, perform ongoing credit
evaluations, and monitor accounts to minimize the risk of loss.

Despite our efforts to minimize credit risk exposure, our customers 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  "Government  Regulation  of  Customers,"  "Service  Agreements  and
Collections" and “Risk Factors” change in such a manner as to negatively impact the cash flows of our customers. If our customers 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,  workers’  compensation  insurance  and  other  self-insurance  programs,  which
comprise approximately 27.1% of our liabilities at December 31, 2020. Under our insurance

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Table of Contents

plans  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,  workers’  compensation  and  other  self-insurance  programs,  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. General liability and workers' compensation reserves for
claims incurred but not reported are developed by a third party actuary through review of our historical data and open claims.

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,

2020

2019
(in thousands)

2018

$

$

87,622  $
(30,828)

39,638 
(14,004)
(5,194)
82,428  $

79,600  $
(35,834)

45,934 
(2,078)
8,022 
87,622  $

84,699 
(34,901)

45,478 
(15,676)
(5,099)
79,600 

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Liquidity and Capital Resources

Cash generated through operations is our primary source of liquidity. At December 31, 2020, we had cash, cash equivalents and marketable securities of $264.3
million and working capital of $410.1 million, compared to December 31, 2019 cash, cash equivalents and marketable securities of $118.0 million and working
capital of $367.1 million. Our current ratio was 3.5 to 1 at December 31, 2020 versus 3.5 to 1 at December 31, 2019. Marketable securities represent fixed income
investments that are highly liquid and can be readily purchased or sold through established markets. Such securities are held by HCSG Insurance to satisfy capital
requirements of the state regulator related to captive insurance companies. Through December 31, 2020, the pandemic has not negatively impacted the Company’s
liquidity position as of such date.

For the year ended December 31, 2020 and 2019, our cash flows were as follows:

Net cash provided by operating activities
Net cash used in investing activities
Net cash used in financing activities

Operating Activities

2020

Year Ended December 31,
2019
(in thousands)

$
$
$

217,213  $
(36,845) $
(68,367) $

93,581  $
(16,457) $
(75,820) $

2018

80,031 
(9,586)
(53,977)

Our  primary  sources  of  cash  from  operating  activities  are  the  revenues  generated  from  our  Housekeeping  and  Dietary  services.  Our  primary  uses  of  cash  from
operating activities are the funding of our payroll and other personnel-related costs, as well as the costs of supplies used in providing our services. For the year
ended December 31, 2020 cash flow from operations included a $46.6 million increase related to the deferral of payroll taxes under the CARES Act which are
payable over two equal installments in December 2021 and 2022. Such deferral, along with 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.

We  have  not  changed  our  expectations  on  future  cash  flows  from  operating  activities  due  to  COVID-19.  We  anticipate  that  several  of  our  customers  may
experience changes in their cash flows however we will continue to pursue collections in accordance with our service agreements.

Investing Activities

Our  principal  uses  of  cash  for  investing  activities  are  the  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.

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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 2020, we paid regular quarterly cash dividends to shareholders totaling $60.7 million as follows:

December 31, 2020

Quarter Ended

September 30, 2020

June 30, 2020
(amounts in thousands, except per share data)

March 31, 2020

Cash dividend per common share
Total cash dividends paid
Record date
Payment date

$
$

0.20500  $
15,322  $

0.20375  $
15,222  $

November 20, 2020
December 24, 2020

August 21, 2020
September 25, 2020

0.20250  $
15,128  $

May 22, 2020
June 26, 2020

0.20125 
15,033 
February 28, 2020
March 27, 2020

Additionally,  on  February  9,  2021,  our  Board  of  Directors  declared  a  regular  quarterly  cash  dividend  of  $0.20625  per  common  share,  which  will  be  paid  on
March 26, 2021 to shareholders of record as of the close of business on February 26, 2021.

The dividends paid to shareholders during the year ended December 31, 2020 were funded by cash generated from operations. Our Board of Directors reviews our
dividend  policy  on  a  quarterly  basis.  Although  there  can  be  no  assurance  that  we  will  continue  to  pay  dividends  or  regarding  the  amount  of  future  dividend
payments, we expect to continue to pay a regular quarterly cash dividend. 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.

We  remain  authorized  to  repurchase  1.6  million  shares  of  our  Common  Stock  pursuant  to  previous  Board  of  Directors’  authorization.  During  the  year  ended
December  31,  2020  and  2019,  we  repurchased  our  Common  Stock  as  part  of  the  dividend  reinvestment  related  to  treasury  shares  held  within  the  Deferred
Compensation Plan. The number of shares and value of shares repurchased were immaterial for the years ended December 31, 2020 and 2019.

Contractual Obligations

Our future contractual  obligations and commitments  at December  31, 2020 primarily  consist of minimum  lease payments on our operating  lease agreements  as
discussed within Note 9 — Lease Commitments. As of December 31, 2020, the Company had no other minimum purchase or capital expenditure commitments
pertaining to our daily operations or existing financing arrangements.

Line of Credit

At December 31, 2020, 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, 2020, there were no borrowings under the
line of credit.

The line of credit requires us to satisfy two financial covenants. The covenants and their respective status at December 31, 2020 were as follows:
Covenant Descriptions and Requirements
2
Funded debt   to EBITDA   ratio: less than 3.50 to 1.00
EBITDA  to Interest Expense ratio: not less than 3.00 to 1.00

As of December 31, 2020
0.19
106.82

2

1

1. All indebtedness for borrowed money including, but not limited to, reimbursement obligations in respect of letters of credit and guarantees of any such indebtedness.

2. Net income plus interest expense, income tax expense, depreciation, amortization, share compensation expense and extraordinary non-recurring losses/gains.

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As noted above, we were in compliance with our financial covenants at December 31, 2020 and we expect to remain in compliance. The line of credit expires on
December 21, 2023. We believe that our existing capacity under the line of credit and our favorable operating cash flows provide adequate liquidity to fund our
operations for the next twelve months following the date of this report, inclusive of the potential impact of COVID-19.

LIBOR is expected to be discontinued after 2021. Our line of credit agreement provides procedures for determining a replacement or alternative rate in the event
that LIBOR is unavailable. However, there can be no assurances as to whether such replacement or alternative rate will be more or less favorable than LIBOR. We
intend to monitor the developments with respect to the potential phasing out of LIBOR after 2021 and will work with our lenders to ensure any transition away
from LIBOR will have minimal impact on our financial condition. We however can provide no assurances regarding the impact of the discontinuation of LIBOR
on the interest rate that we would be required to pay or on our financial condition.

At December  31, 2020, we also had outstanding  $62.9 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 reduced by $62.9 million to $412.1 million at
December 31, 2020. On January 2, 2021 the letters of credit were renewed and expire on January 4, 2022.

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 customer 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 customer
relationships.

We deploy significant resources and have invested in tools and processes to optimize our credit and collections efforts. When appropriate, the Company utilizes
interest-bearing promissory notes to enhance the collectability of amounts due, by instituting definitive repayment plans and providing a means by which to further
evidence the amounts owed. In addition, the Company may amend contracts from full service to management-only arrangements, or adjust contractual payment
terms, to accommodate customers 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.

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 $9.6 million, $25.5 million and $51.4 million in the years ended December 31, 2020, 2019 and 2018, respectively. As a percentage of total
revenues, these provisions represented approximately 0.5%, 1.4% and 2.6% for the years ended December 31, 2020, 2019 and 2018, respectively.

Insurance Programs

We self-insure or carry high deductible insurance plans and therefore 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.

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.

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Table of Contents

Capital Expenditures

The level of capital expenditures is generally dependent on the number of new customers 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 $4.3 million in 2020. Although we have no specific material commitments for capital expenditures through the end of calendar year 2021, we
estimate that for 2021 we will have capital expenditures of approximately $4.0 million to $6.0 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 previously discussed.

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

At December 31, 2020, we had $264.3 million in cash, cash equivalents and marketable securities. The fair value of all of our cash equivalents and marketable
securities are determined based on “Level 1” or “Level 2” inputs, which are based upon 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 in the market. We place our cash investments in instruments that
meet credit quality standards, as specified in our investment policy guidelines.

Investments in both fixed-rate and floating-rate investments carry a degree of interest rate risk. The market value of fixed rate securities may be adversely impacted
by 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.

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Item 8.   Financial Statements and Supplementary Data.

INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm
Consolidated Financial Statements
Consolidated Balance Sheets as of December 31, 2020 and 2019
Consolidated Statements of Comprehensive Income for the Years Ended December 31, 2020, 2019 and 2018
Consolidated Statements of Cash Flows for the Years Ended December 31, 2020, 2019 and 2018
Consolidated Statements of Stockholders' Equity for the Years Ended December 31, 2020, 2019 and 2018
Notes to Consolidated Financial Statements for the Years Ended December 31, 2020, 2019 and 2018

31

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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, 2020 and 2019, the related consolidated statements of comprehensive income, stockholders’ equity, and cash flows for each of the three years
in the period ended December 31, 2020, and the related notes and financial statement schedule 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, 2020 and
2019,  and  the  results  of  its  operations  and  its  cash  flows  for  each  of  the  three  years  in  the  period  ended  December  31,  2020,  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,  2020,  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 February 25, 2021 expressed an unqualified opinion.

Change in accounting principle
As discussed in Notes 1 and 8 to the consolidated financial statements, the Company has changed its method of accounting for allowance for doubtful accounts in
2020  due  to  the  adoption  of  FASB  Accounting  Standards  Codification  subtopic  326  Credit  Losses  –  Measurement  of  Credit  Losses  on  Financial  Instruments
(“ASC 326”).

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 regarding 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.

Critical audit matter
The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be
communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially
challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the financial statements, taken
as  a  whole,  and  we  are  not,  by  communicating  the  critical  audit  matter  below,  providing  a  separate  opinion  on  the  critical  audit  matter  or  on  the  accounts  or
disclosures to which it relates.

Allowance for doubtful accounts, including the impact of ASC 326
As described further in Notes 1 and 8 to the consolidated financial statements, effective January 1, 2020, the Company records an allowance for doubtful accounts
against its accounts and notes receivable balances under ASC 326 based on the future expected credit loss. This guidance replaced the Company’s previous method
to  record  the  allowance  for  doubtful  accounts  under  an  incurred  loss  model  to  estimate  future  credit  losses.  This  estimate  is  determined  based  on  internally
developed  qualitative  and  quantitative  factors  derived  from  the  aging  of  receivables.  We  identified  the  estimates  used  to  determine  the  allowance  for  doubtful
accounts, which includes estimates developed in connection with the Company’s adoption of ASC 326 as a critical audit matter.

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The principal considerations for our determination that the allowance for doubtful accounts, including the adoption of ASC 326, is a critical audit matter, includes
the  high  degree  of  estimation  uncertainty  and  judgment  involved  in  determining  the  estimate.  There  is  also  a  high  degree  of  subjectivity  in  management's
assessment  of  the  reasonableness  of  the  allowance  for  doubtful  accounts,  specifically  the  portion  of  the  receivable  expected  to  be  collected,  which  requires  a
heightened level of auditor judgement in auditing the estimate. Further, variations in this estimate could have a significant impact on the recorded allowance.

Our audit procedures related to the allowance for doubtful accounts and the Company’s adoption of ASC 326 included the following, among others:

• We tested the design and operating effectiveness of controls relating to the allowance for doubtful accounts and the implementation of ASC 326.
• We  evaluated  the  appropriateness  of  management’s  assessment  of  estimating  the  allowance  for  doubtful  accounts  under  ASC  326  and  tested

management’s analysis of the impact of adopting of ASC 326 on the Company’s consolidated financial statements.

• We obtained the Company’s allowance for doubtful account calculations as of January 1, 2020 (ASC 326 effective date) and December 31, 2020, and
tested the reasonableness of management’s estimates and assumptions for a sample of accounts and notes receivable balances by inspecting supporting
documentation, such as legal documents and other correspondence used by management in determining their separate risk pools.

• We performed a historical lookback analysis for a sample of accounts and notes receivable balances within each risk pool, examined current and historical
collection  rates  for  such  balances  and  compared  the  historical  loss  rates  against  the  estimated  loss  rates  within  each  of  the  respective  risk  pools  as  of
January 1, 2020 and December 31, 2020.

• We selected a sample of accounts and notes receivable balances and evaluated the reasonableness of management’s qualitative adjustments against the

allowance for doubtful accounts for such balances by obtaining corroborating evidence which supports the adjustments.

• We  tested  the  mathematical  accuracy  of  management’s  allowance  for  doubtful  accounts  calculation  as  of  January  1,  2020  and  December  31,  2020  by

recalculating the historical loss rates for each risk pool.

We performed analytical procedures on current and historical collection rates and obtained corroborating evidence for any significant variances.

/s/ GRANT THORNTON LLP

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

New York, New York
February 25, 2021

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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, 2020, 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, 2020, 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, 2020, and our report dated February 25, 2021 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
February 25, 2021

34

Table of Contents

ASSETS:
Current assets:

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

As of December 31,

2020

2019

Cash and cash equivalents
Marketable securities, at fair value
Accounts and notes receivable, less allowance for doubtful accounts of $59,906 and $45,726 as of December 31, 2020
and 2019, respectively
Inventories and supplies
Prepaid expenses and other assets

Total current assets
Property and equipment, net
Goodwill
Other intangible assets, less accumulated amortization of $23,466 and $19,300 as of December 31, 2020 and 2019,
respectively
Notes receivable — long–term portion, less allowance for doubtful accounts of $7,895 and $6,667 as of December 31,
2020 and 2019, respectively
Deferred compensation funding, at fair value
Deferred income taxes, net

Total assets

LIABILITIES AND STOCKHOLDERS’ EQUITY:
Current liabilities:
Accounts payable
Accrued payroll and related 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
Accrued payroll and related taxes - noncurrent
Lease liability — long-term portion

Commitments and contingencies

STOCKHOLDERS’ EQUITY:
Common stock, $0.01 par value; 100,000 shares authorized; 75,798 and 75,557 shares issued, and 74,485 and 74,149
shares outstanding as of December 31, 2020 and 2019, respectively
Additional paid-in capital
Retained earnings
Accumulated other comprehensive income, net of taxes
Common stock in treasury, at cost, 1,313 and 1,408 shares as of December 31, 2020 and 2019, respectively
Total stockholders’ equity

Total liabilities and stockholders’ equity

See accompanying notes to consolidated financial statements.
35

$

$

$

$

139,330  $
125,012 

255,474 
31,586 
21,001 
572,403 
26,561 
51,084 

18,187 

34,417 
46,825 
35,554 
785,031  $

52,239  $
70,614 
17,797 
— 
— 
21,610 
162,260 
60,818 
46,827 
23,302 
11,363 

758 
282,206 
200,893 
5,563 
(8,959)
480,461 
785,031  $

27,329 
90,711 

340,930 
36,517 
20,245 
515,732 
28,820 
51,084 

22,353 

46,992 
37,247 
20,364 
722,592 

54,418 
36,413 
16,489 
10,000 
8,075 
23,256 
148,651 
64,366 
37,621 
— 
11,649 

756 
270,614 
195,455 
2,919 
(9,439)
460,305 
722,592 

Table of Contents

Revenues
Operating costs and expenses:
Costs of services provided
Selling, general and administrative expense

Other income (expense):

Investment and other income, net
Interest expense

Income before income taxes

Income tax provision
Net income

Per share data:
Basic earnings per common share
Diluted earnings per common share

Weighted average number of common shares outstanding:
Basic
Diluted

Comprehensive income:
Net income
Other comprehensive income:

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

2020

Years Ended December 31,
2019

2018

$

1,760,303  $

1,840,778  $

2,002,601 

1,612,877 
150,022 

1,768,162 
136,603 

1,492,317 
150,778 

13,352 
(1,374)
129,186 

10,676 
(3,459)
85,096 

30,504 
98,682  $

20,515 
64,581  $

1.32  $

1.32  $

0.87  $

0.87  $

74,696 

74,785 

74,362 

74,590 

5,168 
(3,094)
99,910 

16,386 
83,524 

1.13 

1.12 

74,002 

74,612 

$

$

$

$

$

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

Total comprehensive income

98,682  $

64,581  $

83,524 

2,644 
101,326  $

2,761 
67,342  $

(679)
82,845 

See accompanying notes to consolidated financial statements.
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
Share-based compensation expense
Amortization of premium on marketable securities
Unrealized (gain) loss on deferred compensation fund investments
Loss on sale of assets

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
Income taxes payable
Accrued insurance claims
Deferred compensation liability

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

Net cash used in investing activities

Cash flows from financing activities:

Dividends paid
Reissuance of treasury stock pursuant to Dividend Reinvestment Plan
Proceeds from the exercise of stock options
Repayments of short-term borrowings, net
Payments of statutory withholding on net issuance of restricted stock units

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

2020

Years Ended December 31,
2019

2018

$

98,682  $

64,581  $

83,524 

14,268 
9,636 
(5,893)
7,872 
1,822 
(9,390)
1,335 

46,158 
4,931 
(756)
(52)
(7,250)
59,527 
(8,075)
(5,194)
9,592 
217,213 

274 
(4,341)
(39,047)
6,269 
(36,845)

(60,705)
93 
2,920 
(10,000)
(675)
(68,367)
112,001 
27,329 
139,330  $

1,374  $
44,865  $
—  $

13,940 
25,480 
(684)
6,865 
1,434 
(7,257)
— 

(29,532)
4,765 
3,480 
(738)
(9,532)
3,517 
7,845 
8,482 
935 
93,581 

199 
(4,368)
(33,544)
21,256 
(16,457)

(58,951)
90 
3,628 
(20,000)
(587)
(75,820)
1,304 
26,025 
27,329  $

3,459  $
20,026  $
1,012  $

9,272 
51,387 
(13,013)
5,900 
1,373 
1,429 
— 

(44,363)
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)

(57,201)
89 
8,801 
(5,382)
(284)
(53,977)
16,468 
9,557 
26,025 

3,094 
37,680 
2,291 

$

$
$
$

See accompanying notes to consolidated financial statements.
37

 
 
Table of Contents

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 share-based compensation, net of shares
tendered for payment
Share-based expense
Treasury shares issued for Deferred Compensation Plan funding
Shares issued pursuant to Employee Stock Plan
Dividends paid and accrued, $0.78 per share
Shares issued pursuant to Dividend Reinvestment Plan
Contingent shares settled pursuant to acquisition
Other

Balance, December 31, 2018

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 share-based compensation, net of shares
tendered for payment
Payment of statutory withholding on issuance of restricted stock and
restricted stock units
Share-based expense
Treasury shares issued for Deferred Compensation Plan funding
Shares issued pursuant to Employee Stock Plan
Dividends paid and accrued, $0.80 per share
Shares issued pursuant to Dividend Reinvestment Plan
Contingent shares settled pursuant to acquisition
Other

Balance, December 31, 2019

Adjustment to adopt credit-loss guidance

1

Balance, January 1, 2020

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 share-based compensation, net of shares
tendered for payment
Payment of statutory withholding on issuance of restricted stock and
restricted stock units
Share-based expense
Treasury shares issued for Deferred Compensation Plan funding
Shares issued pursuant to Employee Stock Plan
Dividends paid and accrued, $0.82 per share
Shares issued pursuant to Dividend Reinvestment Plan
Other

Healthcare Services Group, Inc.

Consolidated Statements of Stockholders’ Equity
(in thousands)

Common Stock

Shares

Amount

Additional Paid-
in Capital

Accumulated Other
Comprehensive
Income, net of taxes

Retained Earnings

Treasury Stock

Stockholders’
Equity

74,960 

$

750 

$

244,363 

$

837 

$

163,860 

$

(9,858)

$

399,952 

— 
— 

— 

380 
— 
— 
— 
— 
— 
— 
4 

— 
— 

— 

3 
— 
— 
— 
— 
— 
— 
— 

— 
— 

— 

8,514 
5,580 
519 
2,475 
— 
75 
(2,291)
205 

— 
(679)

— 

— 
— 
— 
— 
— 
— 
— 
— 

83,524 
— 

— 

— 
— 
— 
— 
(57,361)
— 
— 
69 

— 
— 

— 

$

— 
— 
(165)
346 
— 
14 
— 
— 

75,344 

$

753 

$

259,440 

$

158 

$

190,092 

$

(9,663)

$

— 
— 

207 

— 
— 
— 
— 
— 
— 
— 
6 

— 
— 

3 

— 
— 
— 
— 
— 
— 
— 
— 

— 
— 

3,625 

(587)
6,590 
535 
1,781 
— 
68 
(1,012)
174 

75,557 
— 

75,557 

$

$

756 
— 

756 

$

$

270,614 
— 

270,614 

$

$

— 
— 

235 

— 
— 
— 
— 
— 
— 
6 

— 
— 

2 

— 
— 
— 
— 
— 
— 
— 

— 
— 

2,918 

(675)
7,329 
438 
1,329 
— 
66 
187 

— 
2,761 

— 

— 
— 
— 
— 
— 
— 
— 
— 

$

$

2,919 
— 

2,919 

— 
2,644 

— 

— 
— 
— 
— 
— 
— 
— 

64,581 
— 

— 

— 
— 
— 
— 
(59,218)
— 
— 
— 

195,455 
(32,099)

163,356 

98,682 
— 

— 

— 
— 
— 
— 
(61,145)
— 
— 

$

$

$

$

$

$

— 
— 

— 

— 
— 
(147)
349 
— 
22 
— 
— 

(9,439)
— 

(9,439)

— 
— 

— 

— 
— 
(53)
506 
— 
27 
— 

83,524 
(679)

82,845 

8,517 
5,580 
354 
2,821 
(57,361)
89 
(2,291)
274 

440,780 

64,581 
2,761 

67,342 

3,628 

(587)
6,590 
388 
2,130 
(59,218)
90 
(1,012)
174 

460,305 
(32,099)

428,206 

98,682 
2,644 

101,326 

2,920 

(675)
7,329 
385 
1,835 
(61,145)
93 
187 

480,461 

Balance, December 31, 2020

75,798 

$

758 

$

282,206 

$

5,563 

$

200,893 

$

(8,959)

$

1.

See Note 8 — Allowance for Doubtful Accounts herein regarding the new credit-loss guidance

See accompanying notes to consolidated financial statements.
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Table of Contents

Healthcare Services Group, Inc.
Notes to Consolidated Financial Statements
Years Ended December 31, 2020, 2019 and 2018

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 customers
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 customers. In such agreements, the Company is responsible for the day-to-
day management of employees located at the customers’ facilities, as well as for the provision of certain supplies. The Company also provides services on the basis
of  management-only  agreements  for  a  limited  number  of  customers.  In  a  management-only  agreement,  the  Company  provides  management  and  supervisory
services while the customer facility retains payroll responsibility for the non-supervisory staff. The agreements with customers typically provide for a renewable
one year service term, cancellable 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 customers’ housekeeping departments, which are principally responsible for the cleaning, disinfecting and sanitizing of
resident rooms and common areas of a customer’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 customer facility.

Dietary consists of managing the customers’ 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.

Principles of Consolidation

The  financial  statements  have  been  prepared  in  accordance  with  United  States  generally  accepted  accounting  principles  (“U.S.  GAAP”)  and  with  the  rules  and
regulations of the SEC, specifically Regulation S-X and the instructions to Form 10-K. Unless otherwise indicated, all references to years are to the Company's
fiscal year, which ends on December 31.

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.

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,  including  the  potential  future  effects  of  COVID-19.  Management  regularly  evaluates  this  information  to  determine  if  it  is
necessary to update the basis for its estimates and to adjust for known changes.

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

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Table of Contents

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.

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.

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.
The Company currently has bank deposits with financial institutions in the U.S. that exceed FDIC insurance limits.

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,  2020  and  2019,  the  Company  had  marketable  securities  of  $125.0  million  and  $90.7  million,  respectively,  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  consolidated balance  sheets. For  the
years ended December 31, 2020 and 2019, $2.6 million and $2.8 million of unrealized gains related to these investments were recorded in other comprehensive
income,  respectively.  For  the  year  ended  December  31,  2018,  $0.8  million  of  unrealized  losses  related  to  these  marketable  securities  were  recorded  in  other
comprehensive income. 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 credit impairment when an investment's fair value declines below the amortized
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,  2020,
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 credit impairment considerations.

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Table of Contents

Accounts and Notes Receivable

Accounts and notes receivable consist of Housekeeping and Dietary segment trade receivables from contracts with customers. The Company’s payment terms with
customers for services provided are defined within each customer’s service agreement. All accounts receivables are considered short term assets as the Company
does not grant payment terms greater than one year. Accounts receivable initially are recorded at the transaction amount, and are recorded after the Company has
an  unconditional  right  to  payment  where  only  the  passage  of  time  is  required  before  payment  is  received.  Each  reporting  period,  the  Company  evaluates  the
collectability of outstanding receivable balances and records an allowance for doubtful accounts representing an estimate of future expected credit loss. Additions
to the allowance for doubtful accounts are made by recording a charge to bad debt expense reported in costs of services provided.

Notes receivable are initially recorded when accounts receivable are transferred into a promissory note and are recorded as an alternative to accounts receivable to
memorialize an unqualified promise to pay a specific sum, typically with interest, in accordance with a defined payment schedule. The Company’s payment terms
with customers on promissory notes can vary based on several factors and the circumstances of each promissory note, however typically promissory notes mature
over a 1 to 3 year period. Similar to accounts receivable, each reporting period the Company evaluates the collectability of outstanding notes receivable balances
and records an allowance for doubtful accounts representing an estimate of future expected credit losses.

Refer to Note 7 — Accounts and Notes Receivable herein for further information.

Allowance for Doubtful Accounts

The guidance under the FASB Accounting Standards Codification subtopic 326 Credit Losses - Measurement of Credit Losses on Financial Instruments ("ASC
326") became effective and was adopted by the Company prospectively as of January 1, 2020. In adopting ASC 326, the Company replaced its previous incurred
loss impairment model for estimating credit losses on accounts and notes receivables for its reporting of quarterly and annual financial results with an expected loss
model prepared in accordance with ASC 326. While the incurred loss impairment model had the Company recognize credit losses when it was probable that a loss
had been incurred,  ASC 326 requires  the Company to estimate  the lifetime  expected  credit  losses on such instruments  and to record  an allowance  to offset  the
receivables. ASC 326 requires the recognition of credit losses that are expected based on existing accounts and notes receivable as compared to the incurred loss
approach. Accordingly, credit losses under ASC 326 generally are recognized earlier in the life cycle of a receivable than under the Company’s previous incurred
loss model. Modeling must be prepared after considering historical experience, current conditions, and reasonable and supportable economic forecasts to estimate
lifetime expected credit losses. Under the previous incurred loss impairment model, credit losses were recognized when Management determined that it was more
likely than not that a loss had been incurred and such loss was estimable.

Refer to Note 8 — Allowance for Doubtful Accounts herein for further information.

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Table of Contents

The cumulative effect of initially applying the new ASC 326 guidance to the consolidated financial statements on January 1, 2020 was as follows:

Consolidated Statement of Financial Position

December 31, 2019

Cumulative Impact
from Adopting
ASC 326 Guidance
(in thousands)

January 1, 2020

Assets

Short-term accounts and notes receivable, less allowance for doubtful accounts
Notes receivable – long–term portion, less allowance for doubtful accounts
Allowance for doubtful accounts on short-term accounts and notes receivables
Allowance for doubtful accounts on long-term notes receivables
Deferred income taxes, net

Stockholders’ equity
Retained earnings

Inventories and Supplies

$
$
$
$
$

$

340,930  $
46,992  $
(45,726) $
(6,667) $
20,364  $

(41,100) $
(1,136) $
(41,100) $
(1,136) $
10,137  $

299,830 
45,856 
(86,826)
(7,803)
30,501 

195,455  $

(32,099) $

163,356 

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

Revenue Recognition

The Company recognizes revenue from contracts 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 amount of revenue recognized by the Company is based on the consideration
to which the Company is entitled in exchange for providing the contracted goods and services. Refer to Note 2 — Revenue herein for further information.

Leases

The guidance under FASB Accounting Standards Codification subtopic ASC 842 Leases (“ASC 842”) became effective and was adopted by the Company as of
January  1, 2019, by applying  a modified  retrospective  transition  approach which resulted  in the capitalization  of the Company’s existing  operating  leases as of
January 1, 2019. As such, the Company records assets and liabilities on the balance sheet to recognize the rights and obligations arising from leasing arrangements
with contractual terms greater than 12 months, as permitted by U.S. GAAP. A leasing arrangement includes any contract which entitles the Company to the right of
use of an identified tangible asset where there are no restrictions as to the direct of use of the asset, and the Company obtains substantially all of the economic
benefits from the right of use. As of the years ended December 31, 2020 and 2019, the Company was only the lessee of operating lease arrangements.
ASC  842  provided  several  optional  practical  expedients  for  use  in  transition.  The  Company  elected  to  use  what  the  FASB  deemed  the  "package  of  practical
expedients," which allowed the Company to not reassess previous conclusions on lease identification, lease classification and the accounting treatment for initial
direct costs. The Company did not recognize an opening adjustment to retained earnings as a result of the adoption of ASC 842, and prior period amounts continue
to be reported in accordance with previous guidance. Refer to Note 9 — Lease Commitments herein for further information.

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Property and Equipment

Property and equipment, with the exception of those pertaining to leases, 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, 2020, 2019 and 2018 was $10.1 million, $9.7 million and $4.9 million, respectively.

Income Taxes

The Company uses the asset and liability method of accounting for income taxes. Under this method, income tax expense or benefits are recognized for the amount
of taxes payable or refundable for the current period. The Company accrues for probable tax obligations as required, based on facts and circumstances in various
regulatory environments. In addition, deferred tax assets and liabilities are recognized for the expected future tax consequences of temporary differences between
the  financial  reporting  and  tax  bases 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  computed  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.

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, 2020, 2019 and 2018.

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.

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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 annually during the fourth quarter 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 during the years ended December 31, 2020, 2019 or 2018.

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.

Concentrations of Credit Risk

The  Company’s  financial  instruments  that  are  subject  to  credit  risk  are  cash  and  cash  equivalents,  marketable  securities,  deferred  compensation  funding  and
accounts and notes receivable. At December 31, 2020 and 2019, 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 marketable securities are fixed income investments which are highly liquid and can
be readily purchased or sold through established markets.

The  Company’s  customers  are  concentrated  in  the  healthcare  industry  and  are  primarily  providers  of  long-term  care.  The  revenues  of  many  of  the  Company’s
customers 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 customers participate. As a result, the Company may not realize the full effects of such
programs until these laws are fully implemented and governmental agencies issue applicable regulations or guidance.

Significant Customers

For the years ended December 31, 2020, 2019 and 2018, Genesis accounted for $258.7 million or 14.7%, $287.8 million or 15.6% and $386.7 million or 19.3% of
the Company's consolidated revenues, respectively. On August 10, 2020 as part of Genesis' earnings release, Genesis disclosed significant doubt about its ability to
continue  as  a  going  concern.  Since  such  announcement,  the  Company's  collection  activity  from  Genesis  has  been  largely  unaffected  with  the  Company  closely
monitoring  such  Genesis  accounts.  As  of  December  31,  2020,  the  Company  had  outstanding  accounts  receivable  and  notes  receivable  of  $22.5  million  and
$21.3 million, respectively, from Genesis. Although the Company expects to continue its relationship with Genesis, there can be no assurance thereof. The loss of
such customer, or a significant reduction in the revenues the Company receives from such customer, could have a material adverse effect on the Company’s results
of operations. In addition, if Genesis fails to abide by 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

Other than the adoption of FASB ASC 326, as discussed within Note 8 — Allowance for Doubtful Accounts, there have been no new accounting pronouncements
that have significance, or potential significance, to our Consolidated Financial Statements.

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Note 2 — Revenue

The Company presents its consolidated revenues disaggregated 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 $895.3 million, $909.5 million and $967.6 million of the Company’s consolidated revenues for the years ended December 31, 2020,
2019  and  2018,  respectively.  The  Housekeeping  services  include  managing  customers’  housekeeping  departments,  which  are  principally  responsible  for  the
cleaning, disinfecting and sanitizing of resident rooms and common areas of the customers’ facilities, as well as the laundering and processing of the bed linens,
uniforms,  resident  personal  clothing  and  other  assorted  linen  items  utilized  at  the  customers’  facilities.  Upon  beginning  service  with  a  customer  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  customer  requests.  Such  management  personnel  also
oversee the execution of various cost and quality control procedures including continuous training and employee evaluation.

Dietary

Dietary services accounted  for $865.0 million,  $931.3 million  and $1,035.0 million  of the Company’s consolidated revenues for the years ended December  31,
2020, 2019 and 2018, respectively.  Dietary services consist of managing customers’ 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 customers. Upon beginning service
with a customer 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 customer requests. Such management
personnel also oversee the execution of various cost and quality control procedures including continuous training and employee evaluation.

Revenue Recognition

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 is 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 its contracts with its customers. Such contracts typically provide for a renewable one year
service term, cancellable by either party upon 30 to 90 days’ notice, after an initial period of 60 to 120 days. A performance obligation is the unit of account under
ASC 606 and is defined as a promise in a contract to transfer a distinct good or service to the customer. 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 that are substantially the same and that have the same
pattern of transfer to the customer. 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 customers’ 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  $0.1  million  and  $0.3  million  as  of
December  31,  2020  and  December  31,  2019,  respectively.  Additionally,  substantially  all  such  revenue  amounts  deferred  as  of  December  31,  2019  were
subsequently recognized as revenue during the year ended December 31, 2020.

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The transaction price is the amount of consideration to which the Company is 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 the Company 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 payment terms 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. In some cases, the Company requires customers to pay in advance for goods and services to be provided. As of
December  31,  2020  and  2019,  the  value  of  the  contract  liabilities  associated  with  customer  prepayments  was  $2.3  million  and  $2.8  million,  respectively.
Additionally, all such revenue amounts deferred as of December 31, 2019 were subsequently recognized as revenue during the year ended December 31, 2020.

Transaction Price Allocated to 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 Company’s contracts with
customers typically provide for an initial term of one year, with renewable one year service terms, cancellable by either party upon 30 to 90 days’ notice after an
initial period of 60 to 120 days.

At December 31, 2020, the Company had $449.9 million related to performance obligations that were unsatisfied or partially unsatisfied for which the Company
expects  to  recognize  revenue.  The  Company  expects  to  recognize  revenue  on  approximately  31.6%  of  the  remaining  performance  obligations  over  the  next  12
months, with the balance to be recognized thereafter. These amounts exclude variable consideration primarily related to performance obligations that consists of a
series of distinct service periods with revenues based on future performance that cannot be estimated at contract inception. The Company also has elected to apply
the practical expedient that permits exclusion of information about the remaining performance obligations with original expected durations of one year or less.

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Note 3 — Changes in Accumulated Other Comprehensive Income by Component

For the years ended December 31, 2020, 2019 and 2018, the Company's accumulated other comprehensive income consisted of unrealized gains and losses from
the Company’s available-for-sale marketable securities. The following tables provide a summary of the changes in accumulated other comprehensive income, net
of taxes:

Accumulated other comprehensive income — beginning balance
Other comprehensive income (loss) before reclassifications
Losses (gains) reclassified from other comprehensive income
Net current period other comprehensive income (loss)

2

3

Accumulated other comprehensive income — ending balance

Unrealized Gains and (Losses) on Available-for-Sale
Securities
Year Ended December 31,
2019
(in thousands)

2020

2018

1

$

$

2,919  $
2,557 
87 
2,644 
5,563  $

158  $

2,848 
(87)
2,761 
2,919  $

837 
(844)
165 
(679)
158 

1. All amounts are net of tax
2.

Realized gains and losses were recorded pre-tax under “Investment and other income” in the Consolidated Statements of Comprehensive Income. For the years ended
December 31, 2020 and 2018, the Company recorded $0.1 million and $0.2 million of realized losses from the sale of available-for-sale securities, respectively. For
the year ended December 31, 2019, the Company recorded $0.1 million of realized gains 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, 2020 and 2019, the changes in other comprehensive income were both net of a tax expense of $0.7 million. For the year ended
December 31, 2018 the changes in other comprehensive income were net of a tax benefit of $0.1 million.

3.

Amounts Reclassified from Accumulated Other
Comprehensive Income
2019
(in thousands)

2018

2020

Year Ended December 31,
(Losses) gains from the sale of available-for-sale securities
Tax benefit (expense)

Net (loss) gain reclassified from accumulated other comprehensive income

$

$

(114) $
27 
(87) $

111  $
(24)
87  $

(197)
32 
(165)

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Note 4 — Property and Equipment

Property and equipment are recorded at cost. Depreciation is recorded over the estimated useful life of each class of depreciable asset, and is computed using the
straight-line method. 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, 2020 and December 31, 2019:

December 31, 2020

December 31, 2019

Housekeeping and Dietary equipment
Computer hardware and software
Operating lease — right-of-use assets
Other
Total property and equipment, at cost
Less accumulated depreciation

1

Total property and equipment, net

$

$

(in thousands)

13,862  $
6,015 
26,074 
1,581 
47,532 
20,971 
26,561  $

25,219 
12,769 
21,176 
1,698 
60,862 
32,042 
28,820 

1.

Includes furniture and fixtures, leasehold improvements and autos and trucks including auto leases.

Depreciation expense for the years ended December 31, 2020, 2019 and 2018 was $10.1 million, $9.7 million, and $4.9 million, respectively. Of the depreciation
expense recorded for the years ended December 31, 2020 and 2019, $5.6 million and $4.9 million related to the depreciation of the Company’s operating lease -
right-of-use  assets  ("ROU Assets"),  respectively.  For the year  ended December  31, 2018, no depreciation  expense  related  to the  depreciation  of the Company's
ROU Assets was recognized as ASC 842 was adopted on January 1, 2019.

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  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, 2020 and 2019.

Intangible Assets

The Company’s other 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 approximately 10 years. The gross amount of the Company's intangible assets as of December 31, 2020 and 2019 was
$41.7 million.

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The following table sets forth the estimated amortization expense for intangibles subject to amortization for 2021, the following four fiscal years and thereafter:

Period/Year

2021
2022
2023
2024
2025
Thereafter

Total Amortization Expense
(in thousands)

4,165 
4,165 
3,169 
2,035 
2,035 
2,618 

$
$
$
$
$
$

Amortization expense for the years ended December 31, 2020, 2019, and 2018 was $4.2 million, $4.2 million and $4.4 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, 2020 and 2019, the Company recorded unrealized gains, net of taxes
of $2.6 million and $2.8 million on marketable securities, respectively. For the year ended December 31, 2018, the Company recorded an unrealized loss, net of
taxes of $0.7 million on marketable securities.

For the years ended December 31, 2020, 2019 and 2018, the Company received total proceeds, less the amount of interest received of $6.3 million, $21.3 million
and $9.0 million, respectively, from sales of available-for-sale municipal bonds. For the years ended December 31, 2020 and 2018, these sales resulted in realized
losses of $0.1 million and $0.2 million, respectively, and realized gains of $0.1 million for the year ended December 31, 2019. Such gains and losses were recorded
in  “Investment  and  other  income,  net”  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).  For  the  years  ended  December  31,  2020  and  2019,  the  Company
recognized unrealized gains of $9.5 million and $7.4 million, respectively, and unrealized losses of $1.3 million for the year ended December 31, 2018 related to
equity securities still held at the respective reporting dates.

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The  following  tables  provide  fair  value  measurement  information  for  the  Company’s  marketable  securities  and  deferred  compensation  fund  investments  as  of
December 31, 2020 and December 31, 2019:

Financial Assets:
Marketable securities

Municipal bonds — available-for-sale

Deferred compensation fund

1

Money Market 
Balanced and Lifestyle
Large Cap Growth
Small Cap Growth
Fixed Income
International
Mid Cap Growth

Deferred compensation fund

Financial Assets:
Marketable securities

Municipal bonds — available-for-sale

Deferred compensation fund

1

Money Market 
Balanced and Lifestyle
Large Cap Growth
Small Cap Growth
Fixed Income
International
Mid Cap Growth

Deferred compensation fund

Carrying Amount

Total Fair Value

As of December 31, 2020

Fair Value Measurement Using:

Significant Other
Observable Inputs
(Level 2)

Significant Unobservable
Inputs (Level 3)

Quoted Prices
in Active Markets
(Level 1)
(in thousands)

125,012  $

125,012  $

—  $

125,012  $

3,006  $
10,815 
17,223 
5,337 
4,850 
2,250 
3,344 
46,825  $

3,006  $
10,815 
17,223 
5,337 
4,850 
2,250 
3,344 
46,825  $

—  $

10,815 
17,223 
5,337 
4,850 
2,250 
3,344 
43,819  $

3,006  $
— 
— 
— 
— 
— 
— 
3,006  $

— 

— 
— 
— 
— 
— 
— 
— 
— 

Carrying 
Amount

Total Fair 
Value

As of December 31, 2019

Fair Value Measurement Using:

Significant Other
Observable Inputs
(Level 2)

Significant Unobservable
Inputs (Level 3)

Quoted Prices
in Active Markets
(Level 1)
(in thousands)

90,711  $

90,711  $

—  $

90,711  $

2,625  $
10,294 
11,369 
4,120 
4,072 
1,932 
2,835 
37,247  $

2,625  $

10,294 
11,369 
4,120 
4,072 
1,932 
2,835 
37,247  $

—  $

10,294 
11,369 
4,120 
4,072 
1,932 
2,835 
34,622  $

2,625  $
— 
— 
— 
— 
— 
— 
2,625  $

— 

— 
— 
— 
— 
— 
— 
— 
— 

$

$

$

$

$

$

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.

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December 31, 2020
Type of security:
Municipal bonds — available-for-sale

Total debt securities

December 31, 2019
Type of security:
Municipal bonds — available-for-sale

Total debt securities

December 31, 2018

Type of security:
Municipal bonds — available-for-sale
Total debt securities

Amortized Cost

Gross Unrealized
Gains

Gross Unrealized
Losses
(in thousands)

Estimated Fair
Value

Credit Loss 
Impairments

$
$

$
$

$
$

117,970  $
117,970  $

7,043  $
7,043  $

(1) $
(1) $

125,012  $
125,012  $

87,016  $
87,016  $

3,695  $
3,695  $

—  $
—  $

90,711  $
90,711  $

76,162  $
76,162  $

633  $
633  $

(433) $
(433) $

76,362  $
76,362  $

— 
— 

— 
— 

— 
— 

The following table summarizes the contractual maturities of debt securities held at December 31, 2020 and December 31, 2019, 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, 2020

December 31, 2019

(in thousands)
2,927  $
26,324 
55,366 
40,395 
125,012  $

876 
16,071 
38,801 
34,963 
90,711 

$

$

The Company’s accounts and notes receivable balances consisted of the following as of December 31, 2020 and December 31, 2019:

Short-term

Accounts and notes receivable
Allowance for doubtful accounts

1

Total net short-term accounts and notes receivable

Long-term

Notes receivable
Allowance for doubtful accounts

1

Total net long-term notes receivable

Total net accounts and notes receivable

December 31, 2020

December 31, 2019

(in thousands)

$

$

$

$
$

315,380  $
(59,906)
255,474  $

42,312  $
(7,895)
34,417  $
289,891  $

386,656 
(45,726)
340,930 

53,659 
(6,667)
46,992 
387,922 

1.

Effective January 1, 2020, the Company adopted ASC 326 and recorded a one-time adoption adjustment of $42.2 million

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Table of Contents

The Company makes credit decisions on a case-by-case basis after reviewing a number of qualitative and quantitative factors related to the specific customer as
well  as  current  industry  variables  that  may  impact  that  customer.  There  are  a  variety  of  factors  that  impact  a  customer’s  ability  to  pay  in  accordance  with  the
Company’s contracts. These factors include, but are not limited to, fluctuating census numbers, litigation costs and the customer’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 customer’s cash flows
and its ability  to make timely  payments. However, the customer’s  obligation  to pay the Company in accordance  with the contracts  are not contingent  upon the
customer’s cash flow. Notwithstanding the Company’s efforts to minimize its credit risk exposure, the aforementioned factors, as well as other factors that impact
customer 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.

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 customer relationships. 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 to enhance the
collectability  of amounts due, by instituting definitive repayment plans and providing a means by which to further evidence the amounts owed. In addition, the
Company may amend contracts from full service to management-only arrangements, or adjust contractual payment terms, to accommodate customers 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.

Note 8 — Allowance for Doubtful Accounts

On January 1, 2020 (the "adoption date"), the Company replaced its previous incurred loss impairment model for estimating credit losses on accounts and notes
receivables with an expected loss model prepared in accordance with ASC 326. While the incurred loss impairment model had the Company recognize credit losses
when  it  was  probable  that  a  loss  had  been  incurred,  ASC  326  requires  the  Company  to  estimate  future  expected  credit  losses  on  such  instruments  before  an
impairment may occur. On the adoption date, the Company recorded an initial increase of $42.2 million to the Company's allowance for doubtful accounts, with an
offset recorded as an opening adjustment to retained earnings.

In making the Company’s credit evaluations, management considers the general collection risk associated with trends in the long-term care industry. The Company
establishes credit limits through payment terms with customers, performs ongoing credit evaluations and monitors accounts on an aging schedule basis to minimize
the risk of loss. Despite the Company’s efforts to minimize credit risk exposure, customers could be adversely affected if future industry trends, including those
related to COVID-19, change in such a manner as to negatively impact their cash flows. The full effects of COVID-19 on the Company’s customers are highly
uncertain  and  cannot  be  predicted.  As  a  result,  the  Company’s  future  collection  experience  can  differ  significantly  from  historical  collection  trends.  If  the
Company’s  customers  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.

The Company evaluates its accounts and notes receivable for expected credit losses quarterly. Accounts receivables are evaluated based on internally developed
credit quality indicators derived from the aging of receivables. Notes receivable are evaluated based on internally developed credit quality indicators derived from
Management’s  assessment  of  collection  risk.  The  Company  manages  note  receivable  portfolios  using  a  two  tiered  approach  by  disaggregating  standard  notes
receivables, which are promissory notes in good standing, from those who have been identified by Management as having an elevated credit risk profile due to a
trigger  event  such  as  bankruptcy.  At  the  end  of  each  period  the  Company  sets  a  reserve  for  expected  credit  losses  on  standard  notes  receivable  based  on  the
Company’s  historical  loss  rate.  Notes  receivable  with  an  elevated  risk  profile,  which  are  from  customers  who  have  filed  bankruptcy,  are  subject  to  collections
activity or are slow payers that are experiencing financial difficulties, are aggregated and evaluated to determine the total reserve for the class of receivable.

The guidance in ASC 326 permits entities to make an accounting policy election not to measure an estimate for credit losses on accrued interest if those entities
write-off accrued interest deemed uncollectible in a timely manner. The Company follows an income recognition policy on all interest earned on notes receivable.
Under such policy the Company accounts for all notes receivable  on a non-accrual  basis and defers the recognition of any interest income until receipt of cash
payments. This policy was established, recognizing the environment of the long-term care industry, and not because such notes receivable are necessarily impaired.
Accordingly,  the  Company  does  not  record  a  credit  loss  adjustment  for  accrued  interest.  For  the  year  ended  December  31,  2020,  the  Company  recognized
$1.7 million in interest income from notes receivables.

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As part of the Company’s adoption of ASC 326, there are additional disclosures required to be made on a class of financing receivable basis. The following table
presents the Company’s two tiers of notes receivable further disaggregated by year of origination, as well as write-off activity for the year ended December 31,
2020:

2020

2019

Notes Receivable
Amortized Cost Basis by Origination Year
2017
(in thousands)

2016

2018

Prior

Total

Notes Receivable
Standard notes receivable
Elevated risk notes receivable

Current-period gross write-offs
Current-period recoveries

Current-period net write-offs

$
$

$

$

12,592  $
—  $

10,474  $
617  $

19,185  $
—  $

22,566  $
3,969  $

28  $
—  $

1,573  $
1,374  $

66,418 
5,960 

—  $
— 
—  $

—  $
— 
—  $

1,748  $
— 
1,748  $

1,540  $
— 
1,540  $

1,970  $
— 
1,970  $

67  $
— 
67  $

5,325 
— 
5,325 

The following table provides information as to the status of payment on the Company’s notes receivable which were past due as of December 31, 2020:

 Age Analysis of Past-Due Notes Receivable as of December 31, 2020

0-90 Days

91 - 180 Days

Greater than 181 Days

Total

Notes Receivable
Standard notes receivable
Elevated risk notes receivable

$

$

1,001  $
253 
1,254  $

(in thousands)

3,794  $
330 
4,124  $

3,712  $
5,377 
9,089  $

8,507 
5,960 
14,467 

The  following  table  provides  a  summary  of  the  changes  in  the  Company’s  allowance  for  doubtful  accounts  on  a  portfolio  segment  basis  for  the  year  ended
December 31, 2020:

Portfolio Segment:

Accounts receivable

Notes receivable
Standard notes receivable
Elevated risk notes receivable

Total notes receivable

Total accounts and notes receivable

$

$

$
$

Allowance for doubtful accounts

December 31, 
2019

Cumulative effect of
ASC 326 adoption
1

2

Write-Offs
(in thousands)

Bad Debt Expense

December 31, 
2020

39,903  $

36,709  $

(31,139) $

5,579  $

51,052 

6,667  $
5,823 
12,490  $
52,393  $

5,236  $
291 
5,527  $
42,236  $

(2,238) $
(3,087)
(5,325) $
(36,464) $

3,593  $
464 
4,057  $
9,636  $

13,258 
3,491 
16,749 
67,801 

Represents the pre-tax one-time adjustment to the Company’s 2020 opening retained earnings balance in accordance with the adoption of the CECL accounting guidance.
1.
2. Write-offs  are  shown  net  of  recoveries.  During  the  year  ended  December  31,  2020,  the  Company  collected  $1.0  million  of  accounts  receivables  that  were  recovered

subsequent to being written-off.

Prior to the adoption date, the allowance for doubtful accounts was established when the Company had determined that receivables have been impaired and the
Company could reasonably estimate the amount of the incurred loss. The allowance for doubtful accounts was evaluated based on the Company’s ongoing review
of accounts and notes receivable and was inherently subjective as it required estimates susceptible to significant revision as more information became available.
For the years ended

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December  31,  2019  and  2018  the  Company  recorded  bad  debt  provisions  (in  an  Allowance  for  Doubtful  Accounts)  of  $25.5  million  and  $51.4  million,
respectively.

Impaired Notes Receivable

Prior  to  the  adoption  date,  the  Company  evaluated  its  notes  receivable  for  impairment  quarterly  and  on  an  individual  customer  basis.  Notes  receivable  were
generally  evaluated  for  impairment  when  the  respective  customers  were  in  bankruptcy,  were  subject  to  collections  activity  or  were  slow  payers  that  were
experiencing financial difficulties. In the event that the evaluation resulted in a determination that a note receivable was impaired, it was valued at the present value
of expected future cash flows or at the market value of related collateral. A summary schedules of impaired notes receivable, and the related reserve, for the years
ended December 31, 2019 and 2018 was as follows:

Year Ended December 31,

2019
2018

Year Ended December 31,

2019
2018

Note 9 — Lease Commitments

Impaired Notes Receivable

Balance Beginning of
Year

Additions

Deductions
(in thousands)

Balance End of Year

Average Outstanding
Balance

$
$

25,704  $
6,854  $

3,763  $
23,382  $

4,830  $
4,532  $

24,637  $
25,704  $

27,554 
15,448 

Reserve for Impaired Notes Receivable

Balance Beginning of
Year

$
$

13,472  $
2,884  $

Additions

Deductions

Balance End of Year

(in thousands)
3,575  $
12,526  $

4,557  $
1,938  $

12,490 
13,472 

The Company recognizes ROU Assets and Lease Liabilities for automobiles, office buildings, IT equipment, and small storage units for the temporary storage of
operational equipment. The Company’s leases have remaining lease terms ranging from less than 1 year to 10 years, and have extension options ranging from 1
year to 5 years. Most leases include the option to terminate the lease within 1 year.

Upon adopting ASC 842, the Company made accounting policy elections using practical expedients offered under the guidance to combine lease and non-lease
components within leasing arrangements and to recognize the payments associated with short-term leases in earnings on a straight-line basis over the lease term,
with the cost associated with variable lease payments recognized when incurred. These accounting policy elections impact the value of the Company’s ROU Assets
and  Lease  Liabilities.  The  value  of  the  Company’s  ROU  Assets  is  determined  as  the  non-depreciated  fair  value  of  its  leasing  arrangements  and  is  recorded  to
Property  and Equipment,  net  on  the Company’s  Consolidated  Balance  Sheets. The  value  of  the Company’s  Lease  Liabilities  is the  present  value  of fixed  lease
payments not yet paid, discounted using either the rate implicit in the lease contract if that rate can be determined, or the Company’s incremental borrowing rate
("IBR"). As of December  31, 2020 and 2019, the Company's short-term  lease obligations  were $5.3 million  and $5.2 million,  respectively,  and are  recorded  in
Other accrued expenses with the remaining balance recognized under the Lease liability — long-term portion captions on the Company’s Consolidated Balance
Sheets.  Any  future  lease  payments  that  are  not  fixed  based  on  the  terms  of  the  lease  contract,  or  fluctuate  based  on  a  factor  other  than  an  index  or  rate,  are
considered variable lease payments and are not included in the value of the Company’s ROU Assets or Lease Liabilities. The Company’s IBR is determined as the
rate of interest that the Company would have to pay to borrow on a collateralized basis over a similar term an amount equal to the lease payments in a similar
economic environment.

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Components of lease expense required by ASC 842 are presented below for the years ended December 31, 2020 and 2019.

Lease cost

Operating lease cost
Short-term lease cost
Variable lease cost
Total lease cost

Year Ended December 31,

2020

2019

(in thousands)

$

$

5,381  $
738 
464 
6,583  $

Supplemental information required by ASC 842 is presented below for the years ended December 31, 2020 and 2019.

Year Ended December 31,

2020

2019

(dollar amounts in thousands)

Other information

Cash paid for amounts included in the measurement of lease liabilities

Operating cash flows from operating leases

ROU Assets obtained in exchange for lease obligations
Weighted-average remaining lease term — operating leases
Weighted-average discount rate — operating leases

1

$
$

$

5,690
5,410
5.4 years
%
4.5 

4,699 
830 
591 
6,120 

4,908
21,366
6.2 years
%
4.7 

1.

ROU Assets obtained in exchange for lease obligations for the year ended December 31, 2019 includes the amount initially capitalized in conjunction with the adoption of
ASC 842.

During  the  years  ended  December  31,  2020  and  2019,  the  Company’s  ROU  Assets  and  Lease  Liabilities  were  reduced  by  $0.6  million  and  $0.3  million,
respectively due to lease cancellations.

The following is a schedule by calendar year of future minimum lease payments under operating leases that have remaining terms as of December 31, 2020:

Period/Year

2021
2022
2023
2024
2025
Thereafter
Total minimum lease payments
Less: imputed lease discount

Present value of lease liabilities

Total expense for all operating leases for the year ended December 31, 2018 was $4.0 million.

55

Operating Leases
(in thousands)

5,322 
4,199 
2,329 
1,299 
1,311 
4,204 
18,664 
1,962 
16,702 

$
$
$

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Note 10 — Share-Based Compensation

The components of the Company’s shared-based compensation expense for the years ended December 31, 2020, 2019 and 2018 are as follows:

Stock options
Restricted stock and restricted stock units
Employee Stock Purchase Plan

Total pre-tax share-based compensation expense charged against income

1

Total recognized tax (deficiency) benefit related to share-based compensation

2020

Year Ended December 31,
2019
(in thousands)

2018

2,134  $
5,195 
543 
7,872  $

2,623  $
3,967 
275 
6,865  $

(293) $

196  $

2,989 
2,591 
320 
5,900 

1,480 

$

$

$

1.

Share-based  compensation  expense  is  recorded  in  cost  of  services  and  selling,  general  and  administrative  expense  in  the  Company’s  Consolidated  Statements  of
Comprehensive Income.

At  December  31,  2020  and  2019,  the  unrecognized  compensation  cost  related  to  unvested  stock  options  and  awards  was  $16.7  million  and  $16.1  million,
respectively.  The  weighted  average  period  over  which  these  awards  will  vest  was  approximately  2.6  years  as  of  December  31,  2020  and  2.4  years  as  of
December 31, 2019.

2020 Omnibus Incentive Plan

On  May  26,  2020,  the  Company  adopted  the  2020  Omnibus  Incentive  Plan  (the  "2020  Plan")  after  approval  by  the  Company's  Shareholders.  The  2020  Plan
provides that current or prospective officers, employees, non-employee directors and advisors can receive share-based awards such as stock options, performance
stock units, restricted stock units and other stock awards. The 2020 Plan seeks to encourage profitability and growth of the Company through short-term and long-
term incentives that are consistent with the Company's operating objectives.

As of December 31, 2020, there were 5.2 million shares of common stock reserved for issuance under the 2020 Plan, of which, 2.5 million are available for future
grant. The amount of shares available for issuance under the 2020 Plan will increase when outstanding awards under the Company's Second Amended and Restated
2012 Equity Incentive Plan (the “2012 Plan”) are subsequently forfeited, terminated, lapsed, or satisfied thereunder in cash or property other than shares. No stock
award will have a term in excess of 10 years. The Nominating, Compensation and Stock Option Committee of the Board of Directors is responsible for determining
the terms of the grants in accordance with the 2020 Plan.

2012 Equity Incentive Plan

The 2012 Plan was replaced by the 2020 Plan on May 26, 2020. Accordingly, no new equity awards will be granted under the 2012 Plan.

Stock Options

A summary of stock options outstanding under the 2020 Plan and the 2012 Plan as of December 31, 2020 and changes during 2020 are as follows:

December 31, 2019
Granted
Exercised
Forfeited
Expired

December 31, 2020

Stock Options Outstanding

Number of Shares
(in thousands)

Weighted Average Exercise Price

2,107  $
215  $
(164) $
(12) $
(48) $
2,098  $

32.99 
24.49 
17.12 
37.65 
32.12 
33.35 

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The weighted average grant-date fair value of stock options granted during the years ended December 31, 2020, 2019, and 2018 was $4.66, $8.18 and $10.48 per
common  share,  respectively.  The  total  intrinsic  value  of  stock  options  exercised  during  the  years  ended  December  31,  2020,  2019  and  2018  was  $1.3  million,
$5.5  million  and  $7.8  million,  respectively.  The  total  fair  value  of  stock  options  vested  during  the  years  ended  December  31,  2020,  2019  and  2018  were
$2.6 million, $3.0 million and $3.7 million, respectively.

For the years ended December 31, 2020, 2019 and 2018, the tax benefit realized from stock options exercised were $0.1 million, $0.2 million and $1.0 million,
respectively.

The fair value of stock option awards granted in 2020, 2019 and 2018 were estimated on the dates of grant using the Black-Scholes option valuation model with the
following assumptions:

Risk-free interest rate
Weighted average expected life
Expected volatility
Dividend yield

2020

Year Ended December 31,
2019

2018

1.8 %
6.6 years
26.5 %
3.2 %

2.5 %
5.7 years
22.6 %
1.9 %

2.1 %
5.8 years
21.5 %
1.5 %

The following table summarizes other information about the stock options at December 31, 2020:

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

December 31, 2020
(amounts in thousands, except per share
data)

$

$
$

2,720 
5.3 years

1,375 
31.78 
1,944 
4.2 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. During the
years ended December 31, 2020, 2019 and 2018 the Company granted 0.3 million, 0.2 million, and 0.1 million restricted stock units with weighted average grant
date fair values of $24.43, $40.49, and $52.06 per unit, respectively. During the years ended December 31, 2020, 2019 and 2018, the Company did not grant any
restricted stock.

A summary of the outstanding restricted stock units and restricted  stock as of December 31, 2019 and changes during the year ended December 31, 2020 is as
follows:

December 31, 2019
Granted
Vested
Forfeited

December 31, 2020

Restricted Stock Units and Restricted Stock

Number
(in thousands)

Weighted Average Grant Date
Fair Value

362 
309 
(94)
(16)
561 

$
$
$
$
$

43.24 
24.43 
42.40 
32.54 
33.31 

The weighted average remaining vesting period for the unvested restricted stock units and restricted stock is 3.2 years.

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Table of Contents

The weighted average grant-date fair values and total fair values of restricted stock units and restricted stock vested during 2020, 2019 and 2018 were as follows:

2020

Year Ended December 31,
2019
(in thousands, except per share data)

2018

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

$
$

24.43  $
2,287  $

40.49  $
2,399  $

52.06 
1,822 

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 its common stock to its employees. Pursuant to such authorization, there are 2.1
million shares available for future grant at December 31, 2020. 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, 2020, 2019 and 2018:

Common shares purchased
Per common share purchase price

Deferred Compensation Plan

2020

Year Ended December 31,
2019
(in thousands, except per share data)
73 
20.67  $

75 
20.67  $

2018

53 
34.15 

$

The Company offers a Supplemental Executive Retirement Plan (“SERP”) for executives and certain key 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 the Company’s 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 1.0 million shares of its common stock to its employees. Pursuant to such authorization, the Company has 0.3
million shares available for future grant at December 31, 2020. At the time of issuance, such shares are accounted for at cost as treasury stock. At December 31,
2020, approximately 0.3 million of such shares are vested and remain in the respective active participants' accounts with the trustee.

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Table of Contents

The following table summarizes information about the SERP during the plan years ended December 31, 2020, 2019 and 2018:

1

SERP expense 
Treasury shares issued to fund SERP expense
Year end SERP trust account balance
Unrealized gain (loss) recorded in SERP liability account

2

3

2020

Year Ended December 31,
2019
(in thousands)

2018

$

$
$

512  $
18 
54,729  $
9,200  $

539  $
22 
43,952  $
7,353  $

547 
14 
39,766 
(1,469)

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.

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.

Note 12 — Dividends

The Company has paid regular quarterly cash dividends since the second quarter of 2003. During the year ended December 31, 2020, the Company paid regular
quarterly cash dividends totaling approximately $60.7 million as follows:

December 31, 2020

Quarter Ended

September 30, 2020

June 30, 2020
(amounts in thousands, except per share data)

March 31, 2020

Cash dividend per common share
Total cash dividends paid
Record date
Payment date

$
$

0.20500  $
15,322  $

0.20375  $
15,222  $

November 20, 2020
December 24, 2020

August 21, 2020
September 25, 2020

0.20250  $
15,128  $

May 22, 2020
June 26, 2020

0.20125 
15,033 
February 28, 2020
March 27, 2020

Cash dividends declared on the Company's outstanding weighted average number of basic common shares for the years ended December 31, 2020, 2019 and 2018
were as follows:

Cash dividends declared per common share

2020

Year Ended December 31,
2019

2018

$

0.81750  $

0.79750  $

0.77750 

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Note 13 — Income Taxes

The following table summarizes the provision for income taxes:

Current:
Federal
State

Deferred:
Federal
State

Tax provision

2020

Year Ended December 31,
2019
(amounts in thousands)

2018

$

$

$

$

$

28,833  $
7,564 
36,397  $

(4,903) $
(990)
(5,893) $

15,041  $
6,158 
21,199  $

(824) $
140 
(684) $

23,407 
5,992 
29,399 

(9,526)
(3,487)
(13,013)

30,504  $

20,515  $

16,386 

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.

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

Deferred tax assets:

Allowance for doubtful accounts
Deferred compensation
Deferred payroll taxes under the CARES Act
Accrued insurance claims
Non-deductible reserves
Leases
Other

Deferred tax liabilities:

Expensing of housekeeping supplies
Amortization of intangibles
Depreciation of property and equipment
Leases
Other

Net deferred tax assets

Year Ended December 31,

2020

2019

(in thousands)

16,672  $
8,239 
11,914 
5,189 
309 
181 
1,466 
43,970  $

(3,322) $
(574)
(1,725)
— 
(2,795)
(8,416) $

13,376 
8,074 
— 
4,902 
489 
— 
1,641 
28,482 

(3,796)
(218)
(1,969)
(96)
(2,039)
(8,118)

35,554  $

20,364 

$

$

$

$

$

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

60

 
 
Table of Contents

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
Share-based compensation
Other, net

Income tax expense

2020

Year Ended December 31,
2019
(in thousands)

2018

27,129  $

17,872  $

20,981 

4,985 
(3,089)
(323)
1,323 
479 
30,504  $

4,902 
(3,164)
(399)
298 
1,006 
20,515  $

1,936 
(5,006)
(384)
(1,179)
38 
16,386 

$

$

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, 2015. 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, 2020 and 2019 is omitted as there is no activity to
report in such account for the years ended December 31, 2020 or 2019.

Note 14 — Related Party Transactions

For the years ended December 31, 2020, 2019 and 2018, the Company did not have any related party transactions.

Note 15 — Segment Information

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 customer 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 contracts, 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,  debt  expense,  information  technology  costs,  depreciation,
amortization of finite-lived intangible assets, share based compensation costs and other corporate-specific costs, are not fully 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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Table of Contents

Revenues

1

Housekeeping
Dietary

Consolidated

Income before income taxes

Housekeeping
Dietary
Corporate
Consolidated

2

Depreciation and amortization

Housekeeping
Dietary
Corporate
Consolidated

Total assets

Housekeeping
Dietary
Corporate
Consolidated

3

Capital expenditures
Housekeeping
Dietary
Corporate

Consolidated

2020

Year Ended December 31,
2019
(in thousands)

2018

895,267  $
865,036 
1,760,303  $

909,499  $
931,279 
1,840,778  $

967,606 
1,034,995 
2,002,601 

95,723  $
68,293 
(34,830)
129,186  $

5,722  $
2,394 
6,152 
14,268  $

214,500  $
174,866 
395,665 
785,031  $

3,710  $
393 
238 
4,341  $

94,173  $
43,269 
(52,346)
85,096  $

5,945  $
2,422 
5,573 
13,940  $

265,096  $
236,075 
221,421 
722,592  $

3,188  $
68 
1,112 
4,368  $

105,904 
60,562 
(66,556)
99,910 

6,315 
2,433 
524 
9,272 

291,117 
235,183 
166,303 
692,603 

3,996 
690 
254 
4,940 

$

$

$

$

$

$

$

$

$

$

1.

2.

3.

For the years ended December 31, 2020 and 2019, both the Housekeeping and Dietary segments earned revenue from several significant customers, although Genesis was
the only customer to contribute for more than 10% of consolidated revenue. For the years ended December 31, 2020, 2019 and 2018, Genesis accounted for $258.7 million
or 14.7%, $287.8 million or 15.6% and $386.7 million or 19.3% of the Company's consolidated revenues, respectively.
Primarily represents corporate office costs 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 other income and interest expense.
Primarily consists of cash and cash equivalents, marketable securities, deferred income taxes and other current and noncurrent assets.

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Table of Contents

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 2020,
2019 and 2018:

Weighted average number of common shares outstanding - basic
1
Effect of dilutive securities 

Weighted average number of common shares outstanding - diluted

2020

Year Ended December 31,
2019
(in thousands)

2018

74,696 
89 
74,785 

74,362 
228 
74,590 

74,002 
610 
74,612 

1.

Certain  outstanding  equity  awards  are  anti-dilutive  and  therefore  were  excluded  from  the  calculation  of  the  weighted  average  number  of  diluted  common  shares
outstanding.

Anti-dilutive outstanding equity awards under share-based compensation plans were as follows:

Anti-dilutive

Note 17 — Contractual Obligations and Other Contingencies

Line of Credit

2020

Year Ended December 31,
2019
(in thousands)

2018

2,121 

1,682 

659 

At December 31, 2020, the Company 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 float 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). As of December 31, 2020 there were no
borrowings  under  the  line  of  credit.  As  of  December  31,  2019  there  were  $10.0  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, 2020. The line of credit expires on December 21, 2023.

At December  31, 2020, the Company also had outstanding $62.9 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 reduced by $62.9 million
to $412.1 million at December 31, 2020. On January 2, 2021 the letters of credit were renewed and expire on January 4, 2022.

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.

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.

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Table of Contents

As  previously  disclosed,  the  Securities  and  Exchange  Commission  (“SEC”)  is  conducting  an  investigation  into  the  Company’s  earnings  per  share  (“EPS”)
calculation practices. Following receipt of a letter from the SEC in November 2017 regarding its inquiry into those practices followed by a subpoena in March
2018, the Company authorized its outside counsel to conduct an internal investigation, under the direction of the Company’s Audit Committee, into matters related
to  the  SEC  subpoena.  This  investigation  was  completed  in  March  2019  and  the  Company  continues  to  cooperate  with  the  SEC’s  investigation  and  document
requests.

The Company and the SEC have recently commenced discussions regarding a potential resolution of the investigation, which focuses on periods prior to 2018. As
discussions regarding a potential resolution with the SEC are ongoing, Mr. John C. Shea, the Company’s Chief Financial Officer, has notified the Company that he
is taking a temporary leave of absence from his duties, with effect from February 9, 2021. On February 9, 2021, the Board of Directors of the Company appointed
Mr.  Andrew  Brophy  as  the  Company’s  Acting  Principal  Accounting  Officer  with  immediate  effect.  Mr.  Brophy  has  served  as  the  Company’s  Director  of
Accounting since November 2020 and SEC Reporting Manager since January 2018.

On March 22, 2019, a putative shareholder class action lawsuit was filed against the Company and its Chief Executive Officer in the U.S. District Court for the
Eastern District of Pennsylvania. The initial complaint, which was filed by a plaintiff purportedly on behalf of all purchasers of the Company’s securities between
April 11, 2017 and March 4, 2019 (the "Class Period"), alleges violations of the federal securities laws in connection with the matters related to the Company’s
EPS calculation practices. On September 17, 2019, the complaint was amended to, among other things, extend the Class Period to cover the period between April
8, 2014 and March 4, 2019, and to name additional individuals affiliated with the Company as defendants. The lead plaintiff seeks unspecified monetary damages
and other relief on behalf of the plaintiff class.

While  the  Company  is  vigorously  defending  against  all  litigation  claims  asserted,  this  litigation—along  with  the  ongoing  SEC  investigation—could  result  in
substantial  costs  to  the  Company  and  a  diversion  of  the  Company’s  management’s  attention  and  resources,  which  could  harm  its  business.  In  addition,  the
uncertainty of the pending lawsuit or potential filing of additional lawsuits could lead to more volatility and a reduction in the Company’s stock price. At this time
the  Company  is  unable  to  reasonably  estimate  possible  losses  or  form  a  judgment  that  an  unfavorable  outcome  is  either  probable  or  remote.  It  is  not  currently
possible to assess whether or not the outcome of these proceedings may have a material adverse effect on the Company.

Government Regulations

The  Company’s  customers  are  concentrated  in  the  healthcare  industry  and  are  primarily  providers  of  long-term  care  many  of  whom  have  been  significantly
impacted by COVID-19. For those customers who were impacted, the pandemic has resulted in increased operating costs, reductions in new resident admitants, and
reduced census. The revenues of many of the Company’s customers 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 customers participate.
There have been several enacted and proposed federal and state relief measures as a result of COVID-19 which should provide support for these customers during
this  pandemic,  however,  the  full  benefit  of  any  such  programs  would  not  be  realized  until  these  programs  are  fully  implemented,  government  agencies  issue
applicable regulations or guidance and such relief is provided.

Note 18 — Accrued Insurance Claims

The Company currently has a Paid Loss Retrospective Insurance Plan for general liability, workers’ compensation insurance and other self-insurance programs,
which comprised approximately 27.1% and 33.4% of the Company’s liabilities at December 31, 2020 and 2019, respectively. The decline in our self-insurance
liabilities  was  primarily  impacted  by  a  favorable  $14.0  million  adjustment  to  the  Company's  self-insurance  reserves  during  2020  after  considering  our  updated
actuarial  estimates  for  projected  incurred  losses  on  past  claims  as  compared  to  the  $2.1  million  favorable  adjustment  recorded  in  2019.  Under  the  Company’s
insurance plans, 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.

64

Table of Contents

For general liability, workers’ compensation and other self-insurance programs, 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. General liability and workers' compensation
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 filing 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.

65

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 Acting Principal Accounting 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  Acting  Principal
Accounting Officer concluded that as of the end of the period covered by this report, the Company’s disclosure controls and procedures were effective to ensure
that information required to be disclosed by us in reports we file or submit under the Exchange Act is (1) recorded, processed, summarized, and reported within the
time periods specified in the rules and forms of the Securities and Exchange commission, and (2) accumulated and communicated to our management, including
the Company's Chief Executive Officer and Acting Principal Accounting Officer, to allow timely decisions regarding required disclosure.

Management’s Report on Internal Control Over Financial Reporting

The Company's management  is responsible  for establishing and maintaining  adequate internal  control over financial  reporting, as such term is defined in Rules
13a-15(f) and 15d-15(f) of the Exchange Act. Under the supervision and with the participation of the Company's management, including the Company's principal
executive and principal financial officers, management conducted an evaluation of the effectiveness of our internal control over financial reporting based upon the
framework in Internal Control - Integrated Framework (2013), issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on that
evaluation, the Company's management concluded that our internal control over financial reporting was effective as of December 31, 2020.

Audit Report on internal Controls Over Financial Reporting of the Registered Public Accounting Firm

Grant  Thornton  LLP,  the  Company’s  independent  registered  public  accounting  firm  has  audited  the  consolidated  financial  statements  included  in  this  Annual
Report  on  Form  10-K  and,  as  part  of  their  audit,  has  issued  their  report,  included  herein,  on  the  effectiveness  of  the  Company's  internal  control  over  financial
reporting as of December 31, 2020.

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.

Solely for purposes of signing and providing the certifications required under this Form 10-K, Mr. Andrew Brophy our Acting Principal Accounting Officer was
appointed our principal financial officer.

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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 2021 Annual Meeting of Shareholders and to be filed within 120 days of the close of the year ended December 31, 2020.

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 2021 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year ended December 31, 2020.

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 2021 Annual Meeting of Shareholders and to be filed within 120 days
of the close of the fiscal year ending December 31, 2020.

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 2021 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year
ended December 31, 2020.

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 2021 Annual Meeting of Shareholders and to be filed within 120 days of the close of the fiscal year ended December 31, 2020.

67

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 —

a. Schedule II—Valuation and Qualifying Accounts and Reserves; and 
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.

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Table of Contents

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

Additions

Description

2020
Allowance for Doubtful Accounts
2019
Allowance for Doubtful Accounts
2018
Allowance for Doubtful Accounts

Beginning Balance

Charged to Other
Accounts 

(1)

Charged to Costs and
Expenses

Deductions

Ending Balance

(in thousands)

$

$

$

52,393  $

42,236  $

9,636  $

36,464  $

57,209  $

11,985  $

—  $

—  $

25,480  $

30,296  $

51,387  $

6,163  $

67,801 

52,393 

57,209 

1. All amounts charged to other accounts for the year ended December 31, 2020 pertain to the cumulative effect of the Company's January 1, 2020 adoption of ASC 326

as described within Note 1—Description of Business and Significant Accounting Policies.

69

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

Form
10-K

8-K

10-K

S-18

S-8

10-Q

10-Q

—

S-8
8-K

S-3D
—
—
—

—

—

—

Exhibit Number Description

3.1

3.2

3.3

4.1 (P)

4.2†

4.3†

4.5†

4.6

10.1†
10.2

10.3
21
23
31.1

31.2

32.1

101

104

Amended and Restated Articles of Incorporation of the
Registrant as of May 30, 2000
Amendment to the Amended and Restated Articles of
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
Description of the Company's Securities Registered Pursuant
to Section 12 of the Securities Exchange Act of 1934
2020 Omnibus 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 Principal Executive Officer pursuant to
Section 302 of the Sarbanes-Oxley Act
Certification of Principal Financial Officer pursuant to
Section 302 of the Sarbanes-Oxley Act
Certification of the Principal Executive Officer and 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, 2020 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
Cover Page Interactive Data File (formatted as inline XBRL
with applicable taxonomy extension information contained in
Exhibits 101.)

†
(P)

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

Date of Filing
3/21/2001

Exhibit Number
3.2

Filed Herewith
—

2-87625-W

—

333-92835

12/15/1999

File No.
0-12015

0-12015

0-12015

0-12015

0-12015

—

333-240096
0-12015

333-108182
—
—
—

—

—

—

5/24/2007

2/19/2015

10/28/2016

10/22/2012

—

7/24/2020
12/31/2018

8/22/2003
—
—
—

—

—

—

—

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

—

—

70

Table of Contents

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

Signatures

Dated: February 25, 2021

HEALTHCARE SERVICES GROUP, INC.
(Registrant)

By:

 /s/ Theodore Wahl
Theodore Wahl
President & 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

/s/ Theodore Wahl
Theodore Wahl

Title

Director and President & Chief Executive Officer
(Principal Executive Officer)

/s/ Andrew M. Brophy
Andrew M. Brophy

Acting Principal Accounting Officer
(Principal Financial and Accounting Officer )

/s/ Jude Visconto
Jude Visconto

/s/ Michael E. McBryan
Michael E. McBryan

/s/ John M. Briggs
John M. Briggs

/s/ Diane S. Casey
Diane S. Casey

/s/ Robert L. Frome
Robert L. Frome

/s/ Dino D. Ottaviano
Dino D. Ottaviano

/s/ John J. McFadden
John J. McFadden

/s/ Jude Visconto
Jude Visconto

/s/ Daniela Castagnino
Daniela Castagnino

/s/ Laura Grant
Laura Grant

Chairman of the Board

Director

Director

Director

Director

Director

Director

Director

Director

Director

71

Date

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

February 25, 2021

Exhibit 21

Entity Name
HCSG Staff Leasing Solutions, LLC ("Staff
Leasing")
HCSG Insurance Corp.

HCSG Labor Supply, LLC ("Labor Supply")

HCSG East, LLC

HCSG Central, LLC

HCSG West, LLC

HCSG East Labor Supply, LLC

HCSG Clinical Services, LLC

SUBSIDIARIES OF HEALTHCARE SERVICES GROUP, INC.
AS OF DECEMBER 31, 2020
Jurisdiction
Pennsylvania

Year Formed
2011

2014

2014

2015

2015

2015

2015

2017

New Jersey

Pennsylvania

New Jersey

New Jersey

New Jersey

New Jersey

New Jersey

Description
Staff Leasing offers professional employer organization services
to clients in the healthcare industry.
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 February 25, 2021, with respect to the consolidated financial statements 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, 2020. We consent to the incorporation by
reference of said reports in the Registration Statements of Healthcare Services Group, Inc. on Form S-3 (File No. 333-108182, effective August 22, 2003) and on
Forms S-8 (File No. 333-92835, effective December 15, 1999, File No. 333-184612, effective October 26, 2012, File No. 333-234338, effective October 25, 2019
and File No. 333-240096, effective July 24, 2020).

Exhibit 23

/s/ GRANT THORNTON LLP

New York, New York
February 25, 2021

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:

February 25, 2021

/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, Andrew M. Brophy, 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:

February 25, 2021

/s/ Andrew M. Brophy
Andrew M. Brophy
Acting Principal Accounting Officer
(Principal Financial 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, 2020 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, and Andrew M.
Brophy, Acting Principal Accounting Officer, each 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:

February 25, 2021

Date:

February 25, 2021

/s/ Theodore Wahl
Theodore Wahl
President & Chief Executive Officer
(Principal Executive Officer)

/s/ Andrew M. Brophy
Andrew M. Brophy
Acting Principal Accounting Officer
(Principal Financial Officer)