HSTM · Healthstream Inc

The sales reported in this Form 4 were affected pursuant to a Rule 10b5-1 sales plan adopted by the reporting person on November 21, 2025.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning June 6, 2024 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 30, 2025 in three equal installments.

Not applicable.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 29, 2026 in three equal installments.

Not applicable.

1. The sales reported in this Form 4 were affected pursuant to a Rule 10b5-1 sales plan adopted by the reporting person on November 21, 2025.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

The sales reported in this Form 4 were affected pursuant to a Rule 10b5-1 sales plan adopted by the reporting person on November 21, 2025.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSU's are subject to a three year vesting schedule, contingent upon continued service at the time of vesting. The RSU's vest annually beginning May 28, 2027 in three equal installments.

Not applicable.

Shares represent stock the reporting person elected to receive in lieu of cash payable for service on the Company's Board of Directors.

This transaction was executed in multiple trades at prices ranging from $24.01 to $24.10. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transactions were effected.

The options are subject to a four year vesting schedule, contingent upon continued service at the time of vesting. 15% vest on May 8, 2027, 20% vest on May 8, 2028, 20% vest on May 8, 2029, 20% vest on May 8, 2030, and the remaining 25% vest on May 8, 2031.

The options are subject to a four year vesting schedule, contingent upon continued service at the time of vesting. 15% vest on May 8, 2027, 20% vest on May 8, 2028, 20% vest on May 8, 2029, 20% vest on May 8, 2030, and the remaining 25% vest on May 8, 2031.

Shares acquired on vesting of restricted share units.

Shares acquired on vesting of restricted share units.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

Vesting of these RSUs is contingent upon continued service at the time of vesting and the achievement of certain performance criteria. The performance criteria will be established on an annual basis by the Compensation Committee of the Board of Directors. 15% vest on March 23, 2023 for the period January 1, 2022 through December 31, 2022; 20% vest on March 23, 2024 for the period January 1, 2023 through December 31, 2023; 20% vest on March 23, 2025 for the period January 1, 2024 through December 31, 2024; 20% vest on March 23, 2026 for the period January 1, 2025 through December 31, 2025; and 25% vest on March 23, 2027 for the period January 1, 2026 through December 31, 2026. Vesting is determined based on actual performance. The performance criteria for the period January 1, 2025 through December 31, 2025 was achieved; therefore 20% of the awards vested on March 23, 2026.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSUs are subject to a four year vesting schedule, contingent upon continued service at the time of vesting. 15% vest on March 20, 2025, 20% vest on March 20, 2026, 30% vest on March 20, 2027, and the remaining 35% vest on March 20, 2028.

Not applicable.

Each restricted share unit (RSU) represents the contingent right to receive one share of common stock upon vesting of the unit.

The RSUs are subject to a four year vesting schedule, contingent upon continued service at the time of vesting. 15% vest on March 20, 2025, 20% vest on March 20, 2026, 30% vest on March 20, 2027, and the remaining 35% vest on March 20, 2028.

Not applicable.