0001890359-21-000003.txt : 20211110 0001890359-21-000003.hdr.sgml : 20211110 20211110174427 ACCESSION NUMBER: 0001890359-21-000003 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20211101 FILED AS OF DATE: 20211110 DATE AS OF CHANGE: 20211110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simmons Kurt JR CENTRAL INDEX KEY: 0001890359 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 211398075 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE CITY: BENSALEM STATE: PA ZIP: 19020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHCARE SERVICES GROUP INC CENTRAL INDEX KEY: 0000731012 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 232018365 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 BUSINESS PHONE: 2159381661 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 3 1 wf-form3_163658425086628.xml FORM 3 X0206 3 2021-11-01 1 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001890359 Simmons Kurt JR 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 1 0 0 0 /s/ Andrew M. Brophy, by Power of Attorney 2021-11-10 EX-24 2 simmons_poa.htm KURT SIMMONS, JR. POA 10-19-21
POWER OF ATTORNEY

Know all by these presents that the undersigned hereby constitutes and appoints
each of Andrew Brophy, Michael Harrity, and James Culp signing singly, as the
undersigned's true and lawful attorneys-in-fact to:

    1) execute for and on behalf of the undersigned Forms 3, 4 and 5 in
accordance with Section 16 of the Securities Exchange Act of 1934, as
amended (the "Exchange Act") relating to Healthcare Services Group, Inc.
(the "Company");

    2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Forms 3, 4 or 5,
complete and execute any amendment or amendments thereto, and timely file such form
with the United States Securities and Exchange Commission and any stock exchange or
similar authority; and

    3) take any other action of any type whatsoever in connection with the foregoing
which, in the opinion of such attorney-in-fact, may be of benefit to, in the best
interest of, or legally required by, the undersigned, it being understood that the
documents executed by such attorney-in-fact on behalf of the undersigned pursuant to
this Power of Attorney shall be in such form and shall contain such terms and
conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority
to do and perform any and every act and thing whatsoever requisite, necessary, or
proper to be done in the exercise of any of the rights and powers herein granted,
as fully to all intents and purposes as the undersigned might or could do if
personally present, with full power of substitution or revocation, hereby ratifying
and confirming all that each such attorney-in-fact, or each such attorney-in-fact's
substitute or substitutes, shall lawfully do or cause to be done by virtue of this
power of attorney and the rights and powers herein granted. The undersigned
acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at
the request of the undersigned, are not assuming any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act. The undersigned
acknowledges that such attorney-in-fact is not assuming: (i) any liability for the
undersigned's responsibility to comply with the requirements of the Act; (ii) any
liability of the undersigned for any failure to comply with such requirements; or
(iii) any obligation or liability of the undersigned for profit disgorgement under
Section 16(b) of the Act.

This Power of Attorney shall remain in full force and effect until the undersigned
is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's
holdings of and transactions in securities issued by the Company, unless earlier
revoked by the undersigned in a signed writing delivered to the foregoing
attorneys-in-fact.

        IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 19th day of October, 2021.

Signature  /s/ Kurt Simmons, Jr.




Print Name  Kurt Simmons, Jr.