This article presents a research which focuses on customer satisfaction in the health care industry, which has recently shown a heightened awareness of and new interest in quality issues. The research was conducted within a regulated business sector and nursing homes. The purpose of our research is to assist an administrator in such an effort by developing a customer satisfaction survey that could be used by nursing home administrators to measure, on an ongoing basis, the satisfaction of both the nursing home residents and the family members, appointed custodians and concerns friends (FCFs). Focus groups were used to identify quality/satisfaction dimensions from the perspective of nursing home residents and FCFs, these are a cost efficient way to solicit information from participants. Using the participants' statements, we developed statements related to the six dimensions. Four of the dimensions pertain to groups in the home: nurses and aides, administrators, dietary, and housekeeping. The fifth dimension is the amount of empathy exhibited by the staff and the final dimension pertains to a variety of issues related to the home environment. As a result of the licensing power of the state, the ultimate consumers (residents) and FCFs are commonly overlooked. Often nursing home administrators become so caught up in trying to satisfy the state that the satisfaction of the ultimate customers goes unmeasured and in many instances is ignored.