ADMISSIONS | APPLICATIONS

If you are interested in learning more about possible residency at The Inn at Menorah
Park please call us at (315) 446-9111 x180


Application for Residency





  • Does Resident have any of the following completed? (If yes, please provide copies)
  •   Yes
      No
  •   Yes
      No
  •   Yes
      No
  •   Yes
      No


  • (Please include the appropriate Bank/Investment Company)


  • (Please include the appropriate Bank/Investment Company)

  •   Yes
      No
  •   Yes
      No

  •   Yes
      No

  • Both Federal and State laws impose severe penalties for obtaining Medicaid fraudulently. Please note that Federal Law prohibits the transfer of most assets for 60 months prior to applying for Medicaid. This signed application represents accurate disclosure of all assets. This Menorah Park Application for Residency may be used in the future to substantiate any future Medicaid application. I hereby declare that the application represents true and accurate information; I understand that I may be asked to provide supportive documentation to verify this information. Menorah Park reserves the right to have this application updated at lease renewal or prior to a move into the Jewish Health and Rehabilitation Center.

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  • CONTACT US

    Email Us

    4101 East Genesee St.
    Syracuse, NY 13214

    315.446.9111