External peer review of skilled nursing care in Minnesota.

External peer review of each of the 8917 Medicaid patients in 228 Skilled Nursing Facilities in Minnesota demonstrated characteristics and needs of patients and produced documented recommendations for Medical Evaluation Studies to strengthen multiple aspects of treatment programs. As a whole, Medicaid patients were well placed and well cared for. However, wide variations were observed in individual facilities. Principal problem areas were those which prevail in all long term care facilities in this country: weakness of individualized treatment, weakness of restorative goal-oriented treatment, severe mental/emotional/behavioral disabilities, lack of strong leadership in medical and nursing professions, and weakness of psychosocial support programs.