The degree of care furnished primarily to provide room and board, which may or may not include nursing care, training, personal hygiene, and other forms of self or supervisory care, to those persons who are physically or mentally disabled or both AND

Who are not under any specific medical, surgical or psychiatric treatment to reduce the existing disability to the extent medically necessary to enable the patient to live outside an institution providing such care; or

When despite such treatment, there is no reasonable possibility that the disability will be reduced or diminished.