A Persian Gulf War veteran with Alzheimer’s disease was pushed, punched and shoved violently into his wheelchair in a state-run veterans home this spring — allegedly by his caretaker, a man who also worked at a nearby Veterans Affairs hospital and was allowed to remain employed there after being fired from the state facility because of the abuse.
Matthew A. Cox was charged April 2 for “endangering the welfare of an incompetent/physically disabled” person, 60-year-old former Marine Corps Cpl. Albert O’Toole. In a video secretly recorded by O’Toole’s wife on March 1, a person identified as Cox is seen grabbing food away from O’Toole, smacking him and shoving him.
Cox also allegedly struck O’Toole on the head with a broom, and later, off camera, the veteran cried out in pain.
The case generated outrage when it was first reported June 18 by News 12 in New Jersey.
But it drew national attention Sunday when John Tiegen, a former Marine and CIA contractor who defended the U.S. compound in Benghazi, Libya, on Sept. 11, 2012, called out VA Secretary Doug Collins on social media, demanding Cox’s immediate firing.
O’Toole’s wife, Angela Sangro, had contacted News 12 reporter Tara Rosenblum after learning that Cox still worked at the VA Hudson Valley Health Care System despite being fired from the New York State Veterans Home in Montrose.
Cox had been removed from direct duties with patients but remained on staff while his case was adjudicated, according to statement from the VA hospital.
“This is a disgrace,” Tiegen wrote, describing the incident and posting the news report.
“While this disturbing incident didn’t happen at a VA facility, @DeptVetAffairs will immediately initiate removal proceedings for this employee,” Collins wrote.
State veterans homes are not managed by the Department of Veterans Affairs. The VA does, however, pay 100% of the cost of care for veterans living in state homes who have service-connected medical conditions that require full-time care, and it also pays the facilities to ensure that they meet federal standards.
The VA is also required to inspect the homes each year to ensure they meet those strict federal standards.
In fiscal 2023, the VA paid about $1.5 billion for veteran nursing home care provided in state veterans homes, according to the Government Accountability Office.
Shuffled between facilities
In the case of the Montrose facility, the state-run home shares a campus with the VA Hudson Valley hospital and a VA community living center where O’Toole spent three months before he was transferred to the state home.
Sangro told Military Times that her husband, whom she married in 2019, received a head injury while serving in the Corps and later developed dementia. When she became unable to care for him full-time, she placed O’Toole in the long-term care facility at the Hudson Valley VA.
He was transferred to the state facility in December when it was determined he needed a higher level of care.
But nearly as soon as he arrived at the new facility, Sangro noticed changes in behavior. O’Toole became agitated and got into altercations with patients and staff. He scuffled with an 86-year old patient who fell and later died.
Sangro said the staff began heavily medicating her husband, which made his agitation worse.
“They started giving him Klonopin for sleep and then more and more medications, like they were trying to control him, but the medications were doing the opposite,” Sangro said in an interview.
O’Toole was sent multiple times to a psychiatric facility, but his doctor there said he did not have a mental health condition.
Suspected abuse
When Sangro noticed bruises and cuts on her husband, she hid a camera in his room to monitor him. After O’Toole’s primary care physician and psychiatrist asked whether she suspected abuse, she checked the footage, she said.
“I left the hall around 4 o’clock, and that recording started at 4:15,” Sangro said, referring to the video used in the News 12 report that has gone viral. “My gosh, that was only one day.”
She showed the video to her husband’s doctors who in turn notified the authorities.
Sangro said that after Cox was charged, the facility “dumped” her husband at the James J. Peters Department of Veterans Affairs Medical Center in the Bronx, N.Y., without telling her.
O’Toole spent two months there. Sangro said she faced challenges visiting him, but she was thrilled with the care he received.
“They started weaning him off a couple of the medications. They couldn’t understand why he was so heavily medicated,” Sangro said. “I have nothing but great things to say about that VA and the VA facility at Montrose. It may be old and run-down, but the staff is so caring and loving. They cut his hair, they shaved him often, they let him walk around the halls. They really took great care of him.”
O’Toole has now returned to the state facility, where he has been placed in isolation and attended to by a four-person staff.
“He is deteriorating,” Sangro said of her 60-year-old husband. “He doesn’t have much time left.”
Calls for an investigation
The incident has generated calls for an investigation from New York state legislators. During a town hall Monday, Sangro and lawmakers, including State Sen. Pete Harckham, said they were outraged by the abuse.
“We [have] called for an investigation from the [state] attorney general and also from the Health Department that runs this facility,” Harckham said. “This is not just an isolated case. This cannot happen in a vacuum. Where is the supervision? Didn’t other people — anyone — notice the bruising, the wounds, the behavior change? This is a symptom of a much larger issue.”
According to state officials, the facility immediately reported the incident to the Office of Aging and Long-Term Care, as well as law enforcement.
Cox was a newer, probationary, part-time employee at the state home who had undergone background checks. He was placed on leave three days after the incident and fired on March 26.
“Maintaining a safe environment for the residents and workers at this facility is our top priority,” Health Department spokeswoman Marissa Crary said in a statement to Military Times. “As soon as we became aware of this incident, the staff member was immediately put on leave, terminated after a review of the incident, and is facing criminal charges.”
Attempts to reach Cox on Wednesday went unanswered.
Westchester County, New York, District Attorney Susan Cacace said in a statement that she was “horrified by the allegations of abuse arising out of” the facility, and her office took action as soon as it was reported.
“Those who make the painstaking decision to place a family member in the care of a veteran’s hospital expect that their loved one will be treated with the dignity befitting a military veteran. Sadly, in this case, it appears that standard of care was not met,” Cacace said.
Cacace added that those with information about mistreatment or abuse at the home or any other facility that cares for veterans should call her office’s Elder Abuse Hotline at (914) 995-8477.
Sangro said that in addition to having concerns regarding Cox’s employment status at the VA, she went public because staff didn’t listen to her when she tried to help her husband. She didn’t want other veterans and family members to suffer, she said.
“He was — is — the love of my life," Sangro said. “Now he doesn’t remember who I am. They took that away from me.”
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
