This is a report of a Congressional hearing held in Jefferson City, Missouri on the crisis in health care for the elderly in Missouri. Representative Ike Skelton's opening statement notes that the purpose of the series of hearings being held around the country, of which this is one, is to examine the effect of changes in the Medicare program on the quality of hospital care senior citizens receive in rural hospitals, and also to review the quality of the Peer Review Organizations (PROs) which are the watchdogs of the health care providers. This hearing focuses specifically on the activities of the Missouri PRO. The first panel of witnesses included the daughter of an elderly patient who had encountered health care delivery problems related to Medicare, the woman's physician who discussed his problems with the PRO, another Medicare beneficiary with medical problems, a health advocacy service coordinator for the elderly, and the president of the Missouri Hospital Association discussing his problems with the PRO and the Health Care Financing Administration. The second panel included two witnesses from the Missouri Patient Care Review Foundation (the PRO for Missouri) and the regional administrator of the Health Care Financing Administration. (ABL)