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This study explored the effect of communication (i.e., among staff, and between staff and clients) and of cultural diversity on job satisfaction (i.e., intrinsic, extrinsic, and general) and perceived service quality of formal caregivers working in elderly services in Macao. We applied a quantitative methodology, based on a cross-sectional design using a self-response questionnaire to 162 staff in six elderly centres in Macao. Based on an extensive review of the literature, we proposed that: H1) cultural diversity is negatively related to (a) intrinsic job satisfaction, (b) extrinsic job satisfaction, (c) general job satisfaction, and (H5) negatively related to perceived competence and service quality; (H2) communication (a) among staff and (b) between staff and clients is positively related to intrinsic job satisfaction (H3) extrinsic job satisfaction, (H4) general job satisfaction, and (H6) perceived service quality; and finally that (H7) intrinsic, (H8) extrinsic, and (H9) general job satisfaction mediate the relationship between (a) cultural diversity, (b) communication among staff and (c) communication between staff and clients, and perceived service quality. We found that more communication among staff was related to higher intrinsic, extrinsic and general job satisfaction, and perceived competence and service quality. And intrinsic job satisfaction mediated the positive effect of communication among staff on perceived service quality. Opposite to predicted communication between staff and clients was related to lower levels of job satisfaction. And cultural diversity was positively related to satisfaction, as well as perceived competence and service quality. The theoretical and practical implications of findings, as well as limitations and suggestions for future research were discussed