Background: Employee performance quality is an important factor in supporting the effectiveness of hospital services. It is influenced not only by individual abilities but also by organizational factors, including internal communication, work environment, compensation, and skill development. Objective: This study aims to analyze the relationship between internal communication, work environment, compensation, and skill development and the performance quality of permanent employees at Cijantung Hospital. Methods: This quantitative study employed a correlational analytical design involving 80 permanent employees selected through total sampling. Data were collected using a Likert-scale questionnaire and analyzed through validity, reliability, classical assumption, Pearson correlation, and multiple linear regression tests. Results: Internal communication was positively and significantly related to employee performance quality (r = 0.528; p = 0.000), as were the work environment (r = 0.488; p = 0.000) and compensation (r = 0.457; p = 0.000). Skill development demonstrated the strongest relationship (r = 0.703; p = 0.000). Multiple linear regression indicated that the four variables were simultaneously significantly related to employee performance quality (F = 32.91; p = 0.000; R² = 0.637), explaining 63.7% of the variance, while 36.3% was attributable to other factors. Conclusion: Improving employee performance quality can be supported by strengthening internal communication, fostering a conducive work environment, providing fair compensation, and implementing sustainable skill development.