en عمومى General پژوهشي Research <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Tahoma;"><span style="line-height:2;"><b>Background:</b> The achievement of elderly health Minimum Service Standards (SPM) reflects the quality of primary healthcare delivery in Indonesia. First-line nurse managers play a crucial role in ensuring these standards through effective management, leadership, and staff satisfaction. This study aimed to analyze the relationship between first-line nurse managers&rsquo; managerial competence and the achievement of elderly health service standards, with job satisfaction as a mediating variable.<br> <b>Methods:</b> A cross-sectional correlational study was conducted from July to August 2025 involving 126 first-line nurse managers from 32 public health centers in Malang City and Regency, Indonesia, recruiting through proportional to size cluster random sampling. Managerial competence was measured using the Primary Care Managerial Competence Scale, while job satisfaction was assessed using the Minnesota Satisfaction Questionnaire (MSQ) short form. Data analysis was performed using Partial Least Squares&ndash;Structural Equation Modeling (PLS-SEM) with SmartPLS version 4.0, with statistical significance set at p<0.05.<br> <b>Results:</b> Managerial competence across eight domains&mdash;leadership, communication, partnership, systematic thinking and decision-making, organizational development and professionalism, emotional intelligence, proactive approach, and information management&mdash;showed no significant direct effect on the achievement of elderly health service standards (&beta; = -0.212, t = 1.924, <i>p</i> = 0.054). However, managerial competence significantly influenced job satisfaction (&beta; = 0.575, t = 8.875, <i>p</i> <0.001), and job satisfaction positively affected SPM achievement (&beta; = 0.257, t = 2.517, <i>p</i> = 0.012), indicating a significant indirect effect (&beta; = 0.148, t = 2.313, <i>p</i> = 0.021). The model demonstrated a good overall fit (GoF = 0.382).<br> <b>Conclusion:</b> Improving nurse managers&rsquo; job satisfaction serves as a critical pathway through which managerial competence contributes to service performance. Strengthening managerial capacity, supported by organizational motivation and capacity-building strategies, is essential to optimize elderly health services in primary care settings.</span></span></span></div> Managerial competence, Job satisfaction, Minimum service standards, First-line nurse managers, Primary care 0 0 http://jccnc.iums.ac.ir/browse.php?a_code=A-10-1214-1&slc_lang=en&sid=1 Rani Rakhmawati rani.rakhma@gmail.com 100319475328460015260 100319475328460015260 Yes Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia Ahsan Ahsan ahsanpsik.fk@ub.ac.id 100319475328460015261 100319475328460015261 No Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia Yati Sri Hayati yshayati.fk@ub.ac.id 100319475328460015262 100319475328460015262 No Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia