Amidst China’s escalating aging population challenge, the efficacy and quality of private elderly care services are garnering increasing scrutiny. This research focuses on evaluating how service quality and customer perceived value influence the loyalty of elderly clients, with customer satisfaction acting as a mediating factor. Grounded in established service quality frameworks and loyalty theories, the study utilizes a quantitative methodology, administering surveys across eight private elderly care institutions in H city, China. A total of 600 surveys were collected, providing a comprehensive data set that encompasses five dimensions of service quality—tangibility, assurance, responsiveness, reliability, and empathy—as well as customer perceived value, satisfaction, and loyalty. Structural Equation Modeling (SEM) was employed to validate the hypothesized relationships. Findings reveal that service quality significantly boosts customer perceived value and satisfaction, which in turn markedly enhance customer loyalty. Notably, customer satisfaction emerged as a crucial mediator between service quality and loyalty, as well as between perceived value and loyalty. This study not only advances theoretical understanding of service quality impacts but also offers actionable insights for enhancing service delivery and customer loyalty in the context of private elderly care.