Application For Admission To The New York Armenian Home Page 2

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DOCUMENTS NEEDED FOR ADMISSION (where applicable)
1. Social Security Number and Card.
2. Naturalization papers or Green Card.
3. Medicare Card.
4. Medicaid Card.
5. Name and address of bank where Social Security check is deposited (if directly
deposited).
6. Amounts of the following:
 Social Security Check
 Life insurance
7. Copies of papers and bank books pertaining to assets
8. Supplemental insurance card or number, if any.
FINANCIAL INFORMATION
“Room rates are for basic services only by State regulations
.
Enhanced Living and Supportive Living Categories
“
”
Will be an assessed case by our Administrator and Doctors for additional charges
.
Converted – private with semi private bath-$3,500.00
Converted – private with private bath - $4,000.00
Single room private bath-$2,800.00
Single room semi-private bath - $2,500.00
Semi private (two persons) share bath with other semi-private-$2,000.00
Semi private first floor residents are $2,500.00 (includes extra care charges)
Additional charge of $500.000 monthly applies to residents in need of extra care
Temporary residency: $700.00 per week
A security deposit of one (1) month is required for all new private and semi-private
residents upon admission.
Personal and/or Social Security checks may make both
payments.
Administrator and Doctors will evaluate all residents as necessary.
ITEMS THAT HAVE TO BE BROUGHT IN BY RESIDENT
Medication, clothing, bathrobe; washcloth, towels, toiletries (as hair brush, comb, tooth
paste, toothbrush, shaving articles, cologne, any and all personal items to be approved by
the Administrator.)

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