Part I--Proposed New Industry Structure for Ambulatory Health Care Services,
Hospitals, Nursing and Residential Care Facilities, and Social Assistance
Section A--NAICS Structure
North American Industry Classification System
(NAICS)
Agreement Number 11
 This Document represents the proposed agreement on the structure of the North American
Industry Classification System (NAICS) for the following industries:  
Ambulatory Health Care Services
Hospitals
Nursing and Residential Care Facilities
Social Assistance
 The detailed NAICS structure along with a brief description of the structure is attached
(Attachments 1 and 2).  Each country agrees to release a copy of the proposed NAICS
structure to interested data users.  Comments received will be shared among the countries and
additional discussions will be held before a final decision on the structure is made.  Each
country may add additional detailed industries, below the 4-digit level of NAICS, as necessary
to meet national needs, so long as this additional detail aggregates to a 4-digit NAICS level in
order to ensure full comparability among the three countries.  This NAICS structure was
presented and provisionally accepted at the NAICS Committee meeting held on September 27,
1995 - September 29, 1995 in Mexico City, Mexico.
Accepted            Signature                 Date
Canada              /S/   Jacob Ryten             9/29/95
Mexico              /S/   Enrique Ordaz           9/29/95
United States            /S/   Jack E. Triplett        9/29/95
ATTACHMENT 1--NAICS STRUCTURE
XX   Ambulatory Health Care Services
XXX    Offices of Physicians
XXXX         Offices of Physicians
XXX    Offices of Dentists
XXXX            Offices of Dentists
XXX    Offices of Other Health Practitioners
XXXX            Offices of Chiropractors
XXXX         Offices of Optometrists
XXXX         Offices of Mental Health Practitioners, except Physicians
XXXX         Offices of Physical, Occupational, and Speech Therapists and                 Audiologists
XXXX         Offices of All Other Health Practitioners
XXX    Outpatient Care Facilities
XXXX            Family Planning Centers
XXXX            Outpatient Mental Health Facilities
XXXX         Other Outpatient Care Facilities
XXX    Medical and Diagnostic Laboratories
XXXX            Medical and Diagnostic Laboratories
XXX    Home Health Care Services
XXXX         Home Health Care Services
XXX    Miscellaneous Ambulatory Health Care Services
XXXX         Ambulance Services
XXXX         Other Miscellaneous Ambulatory Health Care Services
XX   Hospitals
XXX    General Medical and Surgical Hospitals
XXXX            General Medical and Surgical Hospitals
XXX    Psychiatric and Substance Abuse Hospitals
XXXX         Psychiatric and Substance Abuse Hospitals
XXX    Specialty Hospitals, Except Psychiatric and Substance Abuse Hospitals
XXXX         Specialty Hospitals, Except Psychiatric and Substance Abuse                       Hospitals
XX   Nursing and Residential Care Facilities
XXX    Nursing Care Facilities
XXXX            Nursing Care Facilities
XXX    Mental Health, Mental Retardation, and Substance Abuse Facilities
XXXX            Mental Retardation Facilities
XXXX            Mental Health and Substance Abuse Facilities
XXX    Community Care Facilities for the Elderly
XXXX         Community Care Facilities for the Elderly
XXX    Other Residential Care Facilities
XXXX            Other Residential Care Facilities
XX   Social Assistance
XXX    Individual and Family Services
XXXX            Child and Youth Services
XXXX            Services for the Elderly and Persons with Disabilities
XXXX            Other Individual and Family Services
XXX    Community Food, Shelter, and Emergency and Relief Services
XXXX            Community Food Services
XXXX            Community Housing Services
XXXX            Emergency and Other Relief Services
XXX    Job Training and Vocational Rehabilitation Services
XXXX            Job Training and Vocational Rehabilitation Services
XXX    Child Day-care Services
XXXX            Child Day-care Services
Attachment 2--North American Industry Classification System
Draft Classification for:  
     Ambulatory Health Care Services
     Hospitals
     Nursing and Residential Care Facilities
     Social Assistance
     Representatives of the statistical agencies of Canada, Mexico and the United States agree
to a draft classification for these industries.  
     The draft classification constitutes the sector Health and Social Assistance.  The sector is
subdivided into 4 subsectors, 18 industry groups, and 30 industries.
A General Outline
     The health and social services industries provide health care and social assistance for
individuals.  Because it is sometimes difficult to distinguish between the boundaries of health
care and social assistance, these industries are grouped together in a new Health and Social
Assistance sector.  The industries are arranged in order from those providing the most
intensive type of health care to those providing minimal health care with social assistance to
those providing only social assistance to individuals.
     Industries in the Ambulatory Health Care Services subsector provide health care services
directly or indirectly to ambulatory patients and do not usually provide inpatient overnight
services.  Health practitioners in this subsector provide outpatient services, with the facilities
and equipment not usually being the most significant part of the production process.
     The Hospitals subsector includes establishments that provide medical, diagnostic, and
treatment services that include physician, nursing and other health services to inpatients and
the specialized accommodation services required by inpatients.  Hospitals also may provide
outpatient services as a secondary activity.  Establishments in the Hospitals subsector provide
inpatient health services, many of which can only be provided using the specialized facilities
and equipment that form a significant and integral part of the production process.
     The Nursing and Residential Care Facilities subsector includes establishments that provide
residential care combined with either nursing, supervisory or other types of care as required
by the residents.  In this subsector, the facilities are a significant part of the production
process and the care provided is a mix of health and social services with the health services
being largely some level of nursing services.
     The Social Assistance subsector includes establishments that provide a wide variety of
assistance services directly to their clients.  These services do not include residential or
accommodation services except on a short stay basis.
Limitations and Constraints of the Classification
     The draft classification avoids the problem of the delineation of the boundary between
health and social services by incorporating both into a continuum. 
     General Medical and Surgical Hospitals is a very large industry group.  NAICS developers
considered subdividing this NAICS industry; however, research indicated a wide range of
services are typically provided at general medical and surgical hospitals.  Some hospitals
provide specific advanced medical procedures such as organ transplants that require skilled
specialists and special equipment for the operating and recovery phases of the procedures. 
Other hospitals may offer the same or different advanced medical procedures with their
corresponding technologies, along with the less specialized services and less sophisticated
technologies that are offered by virtually all hospitals.  The mix of services and technologies
among hospitals varies significantly along this continuum, but no clear basis for differentiating
among general and surgical hospitals based on their mix of services or technological threshold
was found.
Relationship to ISIC
     All of the 30 industries included in these subsectors are contained within Division 85,
Health and Social Work, in the current International Standard Industrial Classification of All
Economic Activities (ISIC, Revision 3) of the United Nations.  ISIC Division 85, however,
includes veterinary services;  in NAICS, veterinary services are in the Professional, Scientific,
and Technical Services subsector.
Some Changes to the National Classifications
     Changes to the Canadian SIC include splitting CSIC 8621, Homes for Personal and
Nursing Care, into Nursing Care Facilities and Community Care Facilities for the Elderly, and
expanding CSIC 8646, Meal Services (Non-Commercial), to include a broader range of food
services in the new industry Community Food Services.  Community Housing Services and
Emergency and Other Relief Services are essentially new industries for Canada.  Air
ambulance services move out of CSIC 4513, Non-Scheduled Air Transport, Specialty
Industry, to Ambulance Services.  CSIC 8689, Other Health Laboratories, moves out of this
sector.  CSIC 8693, Health Care Research Agencies, moves out of this sector.
     For Mexico, the new Health and Social services sector represents the grouping of medical
and social assistance classified in CMAP groups 9231, Medical, Dental, and Veterinary
Services (Private Sector); 9232, Medical, Dental, and Veterinary Services (Public Sector);
9241, Social Security Services (Private Sector); and 9242, Social Security Services (Public
Sector).  Veterinary services are no longer included in this sector.  A distinction is made
between the public and private sector in CMAP for both health and social services.  Because
this distinction is not maintained in NAICS, it will be made by Mexico at the national
industry level. 
     For the United States, there is a major change to 1987 SIC's  8011, Offices and Clinics of
Doctors of Medicine, and 8031, Offices and Clinics of Doctors of Osteopathy.  NAICS
industry Offices of Physicians now includes both doctors of medicine and doctors of
osteopathy.  The 1987 distinction between the two types of doctors has been eliminated to
recognize the convergence of the two types of medical service.  The training and the
specialities in which the doctors of medicine and doctors of osteopathy are engaged in many
cases are the same and it is more and more common for the two types of doctors to practice
together.  The U.S. will define a separate national industry for physicians who practice mental
health specialties.  In addition to this change to 1987 SIC's 8011 and 8031, HMO medical
centers and ambulatory surgical and free-standing emergency centers have been moved to
NAICS industry Other Outpatient Care Facilities.  The U.S. will recognize separate industries
for these activities in its national detail.  Another major change is the transfer of ambulance
services from 1987 SIC's 4119, Local Passenger Transportation, Not Elsewhere Classified,
and  4522, Air Transportation, Nonscheduled, into Ambulatory Health Care Services.  The
medical services included in the Ambulance Services industry are judged to be of greater
significance than the vehicle used and the significance of the medical service dwarfs the
transportation service also provided.  Dental Laboratories, 1987 SIC 8072,  are moved from
the medical subsector to the Miscellaneous Manufacturing subsector, because making dentures,
crowns, bridgework and artificial teeth is similar to other manufacturing processes classified
there. 
Achievements of Objectives
     The classification meets the objectives for the North American Industry Classification
System (NAICS).  It is comprised of industries that group establishments with similar
production processes, that is, it applies the production-oriented economic concept.  In the
main, the hierarchical structure of the classification also follows the production concept.
     The classification achieves comparability for the three participating countries.  All
countries agree on the definitions of the industries.
     Other objectives of the NAICS project have also been met.  New industries that recognize
current health and social service establishments have been established.  New and emerging
service industries have been created, especially in the area of social assistance.  
     The industries are economically significant.  Some NAICS industries are much larger than
others, but this was necessary to ensure comparability among the countries or because it was
not possible to further subdivide large industries. 
     Finally, disruptions to time series, while they exist, have been minimized to the extent
possible. Most of the changes to time series reflect the changing structure of health care
across the three countries.  For the U.S., additional changes have been made to the national
detail to reflect these changes. 
Section B-Annex: United States National Industry Detail
     As explained in the Structure presentation of this notice, for a number of reasons 4-digit
industries in the four NAICS industry subsectors presented in Part 1, Section A--Attachment
1, contain less detail than is currently in the U.S. SIC system, and less detail than is required
to meet important analytical requirements in the U.S.  The three country agreement on NAICS
envisions that each country may develop national detailed industries below the NAICS
industry level, so long as the national detail can be aggregated to the NAICS classification,
thus assuring full North American comparability.
     The ECPC is proposing U.S. 5-digit industry detail for the four NAICS industry
subsectors covered in Part I of this notice.  For cases where no 5-digit detail is shown, the
ECPC is proposing that the NAICS 4-digit industries will also represent the most detailed
U.S. industries.                                              TABLE 1
The definitions of status codes are as follows: E-existing industry; N-new industry; R-revised industry; and * means "part of".  The abbreviation NEC is used for Not Elsewhere Classified.
1997 NAICS and U.S.  description
      Status
      code   
   1987
   SIC
  code
                                                  
1987 SIC description
XX
Ambulatory Health Care Services
XXX
     Offices of Physicians
XXXX
          Offices of Physicians
XXXXX
               Offices of Physicians except Mental Health Specialists
N
*8011
Offices and Clinics of Doctors of Medicine (except mental
health specialists)                                 
*8031
Offices and Clinics of Doctors of Osteopathy (except  mental
health specialists) 
XXXXX
               Offices of Physicians, Mental Health Specialists
N
*8011
Offices and Clinics of Doctors of Medicine (mental health
specialists)
*8031
Offices and Clinics of Doctors of Osteopathy (mental health
specialists)
XXX
     Offices of Dentists
XXXX
          Offices of Dentists
E
8021
Offices and Clinics of Dentists
XXX
     Offices of Other Health Practitioners
XXXX
          Offices of Chiropractors
E
8041
Offices and Clinics of Chiropractors
XXXX
          Offices of Optometrists
E
8042
Offices and Clinics of Optometrists
XXXX
          Offices of Mental Health Practitioners, except Physicians
N
*8049
Offices and Clinics of Health Practitioners, NEC  (mental
health practitioners except physicians)
XXXX
          Offices of Physical, Occupational, and Speech Therapists and
          Audiologists
N
*8049
Offices and Clinics of Health Practitioners, NEC (physical,
occupational, speech therapists, and audiologists)
XXXX
          Offices of All Other Health Practitioners
XXXXX
               Offices of Podiatrists
E
  8043
Offices and Clinics of Podiatrists
XXXXX
               Miscellaneous Health Practitioners
N
*8049
Offices and Clinics of Health Practitioners, NEC  (except 
mental health practitioners, physical, occupational, speech
therapists, and audiologists)
XXX
     Outpatient Care Facilities
XXXX
          Family Planning Centers
N
*8093
Speciality Outpatient Facilities, NEC (family planning centers)
  *8099
Health and Allied Services, NEC (childbirth preparation)
XXXX
          Outpatient Mental Health Facilities
N
*8093
Specialty Outpatient Facilities, NEC (mental health facilities)
XXXX
          Other Outpatient Care Facilities
XXXXX
               HMO Medical Centers
N
*8011
Offices and Clinics of Doctors of Medicine (HMO Medical
Centers)
XXXXX
               Kidney Dialysis Centers
E
 8092
Kidney Dialysis Centers
XXXXX
               Ambulatory Surgical and Freestanding Emergency Centers
N
*8011
Offices and Clinics of Doctors of Medicine (surgical and
emergency centers)
XXXXX
               All Other Outpatient Care Facilities
N
*8093
Specialty Outpatient Facilities, NEC (except family planning
and mental health centers)
XXX
     Medical and Diagnostic Laboratories
XXXX
          Medical and Diagnostic Laboratories
XXXXX
               Medical Laboratories          
R
*8071
Medical  Laboratories (except diagnostic imaging centers)
XXXXX
               Diagnostic Imaging Centers
N
*8071
Medical Laboratories (diagnostic imaging centers)
XXX
     Home Health Care Services
XXXX
          Home Health Care Services
XXXXX
               Home Health Agencies
N
*8082
Home Health Care Services (home health agencies)
XXXXX
               Other Home Health Care Services
N
*8082
Home Health Care Services (except home health agencies)
XXX
     Miscellaneous Ambulatory Health Care Services
XXXX
          Ambulance Services
N
*4119
Local Passenger Transportation, NEC (land ambulance)
*4522
Air Transportation, Nonscheduled (air ambulance)
XXXX
          Other Miscellaneous Health Care Services
XXXXX
               Blood and Organ Banks
N
*8099
Health and Allied Services, NEC (blood and organ banks)
XXXXX
               All Other Miscellaneous Health Care  Services          
N
*8099
Health and Allied Services, NEC (except blood and organ
banks)
XX
Hospitals
XXX
     General Medical and Surgical Hospitals
XXXX
          General Medical and Surgical Hospitals
R
  8062
General Medical and Surgical Hospitals
*8069
Specialty Hospitals, Except Psychiatric (childrens' hospitals)
XXX
     Psychiatric and Substance Abuse Hospitals
XXXX
          Psychiatric and Substance Abuse Hospitals
R
  8063
Psychiatric Hospitals
*8069
Specialty Hospitals, Except Psychiatric (substance abuse
hospitals)
XXX
     Specialty Hospitals, except Psychiatric and Substance Abuse Hospitals
XXXX
          Specialty Hospitals, except Psychiatric and Substance Abuse
          Hospitals
R
*8069
Specialty Hospitals, Except Psychiatric (except childrens' and
substance abuse hospitals) 
XX
Nursing and Residential Care Facilities
XXX
     Nursing Care Facilities
XXXX
          Nursing Care Facilities
N
*8051
Skilled Nursing Care Facilities (except continuing care
retirement communities)
*8052
Intermediate Care Facilities (except continuing care retirement
communities and mental retardation facilities)
*8059
Nursing and Personal Care Facilities, NEC  (except continuing
care retirement communities)
XXX
     Mental Health, Mental Retardation, and Substance Abuse Facilities
XXXX
          Mental Retardation Facilities
N
*8052
Intermediate Care Facilities (mental retardation facilities)
XXXX
          Mental Health and Substance Abuse Facilities
N
*8361
Residential Care (mental health and substance abuse facilities) 
XXX
     Community Care Facilities for the Elderly
XXXX
          Community Care Facilities for the Elderly
XXXXX
               Continuing Care Retirement Communities 
N
*8051
Skilled Nursing Care Facilities (continuing care retirement
communities)
*8052
Intermediate Care Facilities (continuing care retirement
communities) 
*8059
Nursing and Personal Care Facilities, NEC (continuing care
retirement communities)
XXXXX
               Homes for the Elderly
N
*8361
Residential Care (homes for the elderly)
XXX
     Other Residential Care Facilities
XXXX
          Other Residential Care Facilities
N
*8361
Residential Care (except mental health and substance abuse
facilities, homes for the elderly)
XX
Social Assistance
XXX
     Individual and Family Services
XXXX
          Child and Youth Services
N
*8322
Individual and Family Social Services (child and youth
services)
XXXX
          Services for the Elderly and Persons with Disabilities
N
*8322
Individual and Family Social Services (services for the elderly
and disabled)
XXXX
          Other Individual and Family Services
N
*8322
Individual and Family Social Services (except services for
children, youth, elderly, disabled; food, housing, emergency
and relief)
XXX
     Community Food, Shelter, and Emergency Relief Services
XXXX
          Community Food Services
N
*8322
Individual and Family Social Services (food services)
XXXX
          Community Housing Services
XXXXX
               Temporary Shelter
N
*8322
Individual and Family Social Services (temporary  shelter)
XXXXX
               Other Community Housing Services
N
*8322
Individual and Family Social Services (housing services except
temporary shelter)
XXXX
          Emergency and Other Relief Services
N
*8322
Individual and Family Social Services (emergency and relief
services)
XXX
     Job Training and Vocational Rehabilitation Services
XXXX
          Job Training and Vocational Rehabilitation Services
E
 8331
Job Training and Vocational Rehabilitation Services
XXX
     Child Day Care Services
XXXX
          Child Day-care Services
E
 8351
Child Day Care Services
                                              TABLE 2
   The abbreviation "pt" mean "part of". @ means a time series break has been created that is greater than 3% of the 1992 revenues for the 1987 SIC industry.
1987 SIC code
      1987 SIC description
      1997 U.S. description
4119@
Local Passenger Transportation,  NEC 
Ambulance Services (pt.)
4522@
Air Transportation, Nonschedulaed 
Ambulance Services (pt.)
8011@
Offices and Clinics of Doctors of Medicine
                                                    Clinics of Physicians, Surgical and Emergency Centers
Ambulatory Surgical and Freestanding Emergency Centers
                                                    HMO Medical Centers
HMO Medical Centers
               Offices of Physicians, Mental Health Specialists
Offices of Physicians, Mental Health Specialists (pt.)
               Other Offices of  Physicians
Offices of Physicians, Except Mental Health Specialists (pt.)
8021    
Offices and Clinics of Dentists
Offices of Dentists
8031@
Offices and Clinics of Doctors of Osteopathy
               Offices of Doctors of Osteopathy, Except Mental Health
Offices of Physicians, Except Mental Health Specialists (pt.)
                   Offices of Doctors of Osteopathy, Mental Health Specialists
Offices of Physicians, Mental Health Specialists (pt.)
8041    
Offices and Clinics of Chiropractors
Offices of Chiropractors
8042    
Offices and Clinics of Optometrists
Offices of Optometrists
8043    
Offices and Clinics of Podiatrists
Offices of Podiatrists
8049    
Offices and Clinics of Health Practitioners, Not Elsewhere Classified
               Mental Health Practitioners, Except Physicians
Offices of Mental Health Practitioners, Except Physicians
                   Offices of  Physical, Occupational, and Speech Therapists and
                    Audiologists
Offices of  Physical, Occupational, and Speech Therapists and Audiologists
               Other Offices of  Heath Practitioners
Miscellaneous Health Practitioners
8051@
Skilled Nursing Care Facilities
               Continuing Care Retirement Communities 
Continuing Care Retirement Communities (pt.)
               All Other Skilled Nursing Care Facilities
Nursing Care Facilities (pt.)
8052@
Intermediate Care Facilities
               Continuing Care Retirement Communities 
Continuing Care Retirement Communities (pt.)
               Mental Retardation Facilities
Mental Retardation Facilities
               Other Intermediate Care Facilities
Nursing Care Facilities (pt.)
8059@
Nursing and Personal Care Facilities, Not Elsewhere Classified
               Continuing Care Retirement Communities   
Continuing Care Retirement Communities (pt.)
               Other Nursing and Personal Care Facilities
Nursing Care Facilities (pt.)
8062@    
General Medical and Surgical Hospitals
General Medical and Surgical Hospitals (pt.)
8063@
Psychiatric Hospitals
Psychiatric and Substance Abuse Hospitals (pt.)
8069@
Specialty Hospitals, Except Psychiatric
               Children's Hospitals
General Medical and Surgical Hospitals (pt.)
               Psychiatric and Substance Abuse Hospitals 
Psychiatric and Substance Abuse Hospitals (pt.)
               Other Specialty Hospitals
Specialty Hospitals, Except Psychiatric and Substance Abuse Hospitals
8071    
Medical Laboratories
               Diagnostic Imaging Centers   
Diagnostic Imaging Centers
                   Medical Laboratories, Except Diagnostic Imaging Centers     
Medical Laboratories
8072    
Dental Laboratories
Dental Laboratories (Included in Miscellaneous Manufacturing subsector)
8082    
Home Health Care Services
               Home Health Agencies
Home Health Agencies
                   Home Health Care Services, Except Home Health Agencies
Other Home Health Care Services
8092    
Kidney Dialysis Centers
Kidney Dialysis Centers
8093    
Specialty Outpatient Facilities, Not Elsewhere Classified
               Family Planning Centers
Family Planning Centers
  Outpatient Mental Health Facilities
Outpatient Mental Health Facilities
  Other Specialty Outpatient Facilities
All Other Outpatient Care Facilities
8099
Health and Allied Services, Not Elsewhere Classified
  Blood and Organ Banks
Blood and Organ Banks
  Medical artists
Graphic Design Services (pt.)  (Included in Professional, Scientific, and
Technical Services subsector)
  Medical Photography
Commercial Photography (pt.) (Included in Professional, Scientific, and
Technical Services subsector)       
  Other Health and Allied Services 
All Other Miscellaneous Health Care Services
8322    
Individual and Family Social Services
  Child and Youth Services
Child and Youth Services
  Community Food Services
Community Food Services
    Community Housing Services, Except Temporary Shelters
Other Community Housing Services
  Emergency and Other Relief Services
Emergency and Other Relief Services
  Services for the Elderly and Persons with Disabilities
Services for the Elderly and Persons with Disabilities
  Temporary Shelter
Temporary Shelter
  Other Individual and Family Services
Other Individual and Family Services
8331
Job Training and Vocational Rehabilitation Services
Job Training and Vocational Rehabilitation Services
8351  
Child Day-care Services
Child Day Care Services
8361    
Residential Care
  Homes for the Elderly
Homes for the Elderly
  Mental Health and Substance Abuse Facilities
Mental Health and Substance Abuse Facilities
  Other Residential Care
Other Residential Care Facilities
     Description of Changes to the U.S. System
     
        1.  Ambulatory Health Care Services   Sixteen new NAICS or national industries
     were added to the 1997 industry structure for this subsector to better describe the
     growing and changing U.S. Ambulatory Health Care Services industries.  A number of
     these new industries were created from 1987 Not Elsewhere Classified (NEC)
     industries.  The new industries are:
        Offices of Physicians, except Mental Health Specialists from part of 1987 SIC code
     8011, Offices and Clinics of Doctors of Medicine, and part of 1987 SIC code 8031,
     Offices and Clinics of Doctors of Osteopathy.  In most cases, these two types of
     physicians provide the same services.
        Offices of Physicians, Mental Health Specialists from Part of 1987 SIC code 8011,
     Offices and Clinics of Doctors of Medicine, and part of 1987 SIC code 8031, Offices
     and Clinics of Doctors of Osteopathy.  Mental health is separated from other
     physicians because the production process they use most differs from that used by
     other physicians.
        Offices of Mental Health Practitioners, Except Physicians from part of 1987 SIC
     8049, Offices of Health Practitioners, NEC.  This new industry was created because it
     had a unique production process.  
        Offices of Physical, Occupational, and Speech Therapists and Audiologists from
     part of 1987 SIC 8049, Offices of Health Practitioners, NEC.   This new industry was
     created because it had a unique production process.  
        Miscellaneous Health Practitioners from part of 1987 SIC 8049, Offices and
     Clinics of Health Practitioners, NEC.  This is one of two new residual categories from
     the current NEC category.  It includes only offices of practitioners.
        Family Planning Centers from part of 1987 SIC 8093, Specialty Outpatient Clinics,
     NEC, and part of 1987 SIC 8099, Health and Allied Services, NEC.  This new
     industry was created because it had a unique production process.
        Outpatient Mental Health Facilities from part of 1987 SIC 8093, Specialty
     Outpatient  Clinics, NEC.   This new industry was created because it had a unique
     production process.
        HMO Medical Centers from part of 1987 SIC 8011, Offices and Clinics of Doctors
     of Medicine.  The range of services provided in these centers are generally greater
     than in physician offices.    
        Ambulatory Surgical and Freestanding Emergency Centers from part of 1987 SIC
     8011, Offices and Clinics of Doctors of Medicine.  This  new industry was created
     because it had a unique production process . 
        All Other Outpatient Care Facilities from part of 1987 SIC 8049, Offices and
     Clinics of Health Practitioners, NEC.  This is the second residual category from the
     current NEC.  It contains only outpatient care facilities.
        Diagnostic Imaging Centers from part of 1987 SIC 8071, Medical Laboratories. 
     This new industry was created because it had a unique production process .   
        Home Health Agencies from part of 1987 SIC 8082, Home Health Care Services. 
     This industry provides skilled nursing, physical and other therapy, and other services
     provided in the home.
        Other Home Health Care Services from part of 1987 SIC 8082, Home Health Care
     Services.  This residual of the current industry includes, for example, home inhalation,
     infusion, and perfusion therapy.
     Ambulance Services from parts of 1987 SIC 4119, Local Passenger Transportation,
          Not Elsewhere Classified, and 1987 SIC 4522, Air Transportation, Nonscheduled.  The medical service provided by ambulance personnel is more important than the
     transportation.
        Blood and Organ Banks from part of 1987 SIC 8099, Health and Allied Services,
     NEC.  The new industry was created because it had a unique production process.
        All Other Miscellaneous Health Care Services from part of 1987 SIC 8099, Health
     and Allied Services, NEC.  This is the new residual category for the current 8099.
        2.  Hospitals   There are no new industries, but some content changes were made
     to achieve comparability among the three countries.  These are:
        Children's hospitals were moved from 1987 SIC 8069, Specialty Hospitals, except
     Psychiatric, to General Medical and Surgical Hospitals.  These hospitals provide the
     wide variety of services found in general hospitals.
        Alcohol and drug abuse hospitals were moved from 1987 SIC 8069, Speciality
     Hospitals, except Psychiatric, to form part of Psychiatric and Substance Abuse
     Hospitals to recognize the growing number of these hospitals.
        3.  Nursing and Residential Care Facilities   The three industries in 1987 SIC
     Industry Group 805, Nursing and Personal Care Facilities, and 1987 SIC 8361,
     Residential Care, have been redistributed into five NAICS industries and two
     additional National industries to better describe this growing activity and to eliminate
     the distinction made in 1987 based on the Medicare/Medicaid programs.  The new
     industries are:
        Nursing Care Facilities from parts of 1987 SIC 8051, Skilled Nursing Care
     Facilities; 1987 SIC 8052, Intermediate Care Facilities; and 1987 SIC 8059, Nursing
     and Personal Care Facilities, NEC.  These industries were combined because many
     establishments provide care for persons needing varying levels of health care.
        Mental Retardation Facilities from part of 1987 SIC 8052, Intermediate Care
     Facilities.  This  new industry was created because it had a production process not
     found in nursing homes.   
        Mental Health and Substance Abuse Facilities from part of 1987 SIC 8361,
     Residential Care.  This  new industry was created because it had a unique production
     process.
        Continuing Care Retirement Communities from parts of 1987 SIC 8051, Skilled
     Nursing Care Facilities; 1987 SIC 8052, Intermediate Care Facilities; and 1987 SIC
     8059, Nursing and Personal Care Facilities, NEC.  This new industry was created to
     handle the growing number of establishments having facilities for various levels of
     care at one facility, including nursing care, housekeeping, meal service, and other
     services to assist elderly persons in daily living.
        Homes for the Elderly from part of SIC 1987 8361, Residential Care.  This  new
     industry was created to provide data on establishments known as retirement homes or
     assisted living facilities, where medical care is incidental.
        Other Residential Care Facilities from part of 1987 SIC 8361, Residential Care. 
     This is a new residual category from the current 8361, Residential Care.  
        4. Social Assistance   1989 SIC 8322, Individual and Family Social Services, has
     been split into seven new industries in two industry groups.  These new industries
     reflect the growing and changing character of social assistance industries.  Additional
          industries for social assistance were requested by several organizations interested in activities of not for profit organizations.  These new industries were created to fill that
     need and because the new industries had different production processes.  
        The industries included in the industry group Individual and Family Services are:  
        Child and Youth Services, 
        Services for the Elderly and Persons with Disabilities,
        Other Individual and Family Services
        The industries under the new industry group Community Food, Shelter, and
     Emergency Relief Services are:  
        Community Food Services
        Temporary Shelter (U.S. national industry)
        Other Community Housing Services (U.S. national industry) 
        Emergency and Other Relief Services