This study aims to examine the effects of transformational leadership and organizational culture on employee performance through the mediating role of job satisfaction among employees in the Supporting Healthcare Services Unit of RSUD Sleman. A quantitative explanatory research design was employed using a census sampling technique involving 47 employees, with 46 valid responses analyzed. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling Partial Least Squares (SEM-PLS) with SmartPLS 4. The findings reveal that transformational leadership and organizational culture significantly improve job satisfaction. However, neither transformational leadership nor organizational culture has a significant direct effect on employee performance. Furthermore, job satisfaction does not significantly influence employee performance and fails to mediate the relationships between the independent variables and employee performance. These findings indicate that employee performance in supporting healthcare services is influenced by factors beyond leadership, organizational culture, and job satisfaction. The study extends Stewardship Theory and provides practical insights for strengthening competency development, performance evaluation systems, and organizational effectiveness in public hospitals.
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