How managers 'manage' employees influences important firm outcomes. Heskett, Sasser, and Schlesinger contend that the level of internal support for service workers will influence consumer satisfaction. This study empirically explores how skilled nursing facility (SNF) managers affect consumer satisfaction by encouraging employee effectiveness and listening to employees to determine how to improve employee effectiveness. We extend previous research by proposing management as a form of internal support and demonstrating its relationship to service process integration, as a distinct form of internal support. The results of our individual-level investigation of 630 nursing assistants from 45 SNFs provide support for our two-part hypothesis. First, active management support and process integration, as elements of internal support, do lead to increased employee satisfaction and employee effectiveness. Second, the increased employee satisfaction and effectiveness was positively related to consumer satisfaction, as evaluated by the service workers. Thus, there is a positive influence of management's internal support of nursing assistants on perceived consumer satisfaction.