Our Leadership

Karen Laganelli, MHA
Chief Executive Officer

Karen brings a deep commitment to compassionate care and to the mission of the Sisters of Notre Dame de Namur, and career experience with Notre Dame itself! Karen understands and appreciates the role of mission and its impact on our decisions. She has been a practitioner in primarily not-for-profit post-acute health care since graduating from the University of Massachusetts with a BS in Exercise Science in 1979. She earned her Master’s in Healthcare Administration from Clark University/University of MA Medical School in 1991, and has been a licensed nursing home administrator for almost 30 years. In addition to serving as Administrator for several area facilities, Karen has also worked in Adult Day Health and Dementia Care, and created and operated a certified Hospice program and Hospice Residence. In her role as the Chief Executive for several non-profit organizations before joining Notre Dame in 2015, she has developed a specialty in non-profit management and governance, and completed the merger of two tax-exempt entities in 2009. She continues to serve on industry boards and advisory committees, and presents at conferences on a regular basis.

Senior Leadership Team


keefeSusan Keefe, RN, BSN, CHPN, CHPCA
Executive Director
Notre Dame At Home
Hospice ♦ Pedi Pals ♦ Care Choices

Susan graduated from the University of New England with her Bachelor of Science degree in Nursing. Her passion has been working in homecare, specializing in hospice and palliative care. Susan has been working for Notre Dame Health Care since 2011. She first started as a Nurse Case Manager for the Hospice Division, transitioned to the Clinical Director, and then accepted the position of Executive Director for the At Home Division in 2016. Susan obtained her CHPN (Certified Hospice & Palliative Care Nurse) certification in 2012 and her CHPCA (Certified Hospice and Palliative Care Administrator) in 2017. In 2009, she was proud to accept the Florence Nightingale Award in Nursing Excellence. In 2012 and 2015, Susan was a featured guest presenter at the Hospice and Palliative Care Education Conference. Susan has a strong passion for the nursing profession; she is continuously looking for opportunities to expand her own knowledge while also providing support and education to co-workers, families and the greater community.

steve_totinoStephen Totino
Executive Director of Finance


Steve has been the Executive Director of Finance of Notre Dame Health Care Center (NDHCC)  since June 2004. Prior to his current role on the campus, Steve was involved as a consultant for a small accounting firm for  10 years specializing in Medicaid and Medicare reimbursement for long term care facilities. Steve oversees all aspects of finance operation including oversight of the operating and capital budgets for all divisions at NDHCC.  He also oversees the organizations Information Technology department. Steve received his B.S. in Accounting from Northeastern University.

stevesmallSteve Small, MA, LMHC, PHR
Executive Director of Human Resources


Steven Small joined Notre Dame Health Care as the Executive Director of Human Resources in 2012 and has over 15 years of human resources and management experience. He is recognized by the Society of Human Resources Management (SHRM) as a professional in Human Resources.  Steve is certified by the Occupational Safety and Health Administration (OSHA) as completing the 30-Hour General Industry Safety and Health program. He obtained his Masters of Arts degree in Counseling Psychology, with a certificate in Cognitive-Behavioral Therapy, from Assumption College and is licensed in MA as Mental Health Counselor. 

Michael Randone
Director of Mission Integration

Mike is a graduate of the College of the Holy Cross. He previously worked in the funeral business and also served for twelve years as chaplain at Notre Dame’s St. Julie Billiart Residential Care Center in Ipswich. In this capacity, he learned firsthand about the mission of the Sisters of Notre Dame to make God’s goodness known to every person and the unique and inspiring charism of St. Julie Billiart. He joined Notre Dame Health Care as Director of Mission Integration in January 2019. In this role, he provides leadership to employees in the areas of mission, ethics, and spiritual integration to help ensure a mission centered organizational culture. He works to help employees improve the experience of our residents by helping ensure a connection to mission in all we do in service to our community. In turn, he hopes that by remaining faithful to the mission of St. Julie and the Sisters of Notre Dame, the lives of each person will be affected in a positive, life-enriching way.

Jessica Morreale, MHA, LNHA
Executive Director
Notre Dame du Lac Assisted Living Residence

Jessica holds a Master’s degree from Worcester State University in Healthcare Administration and studied as an undergraduate at the University of Massachusetts and earned a Bachelor’s Degree with a concentration in Social Work and Counseling in 2008. Ms. Morreale brings a wealth of experience in managing care communities in Assisted Living, Hospice, and Skilled Nursing settings. Prior to joining Notre Dame Health Care, Ms. Morreale worked as a Hospice Benefit Educator with Kindred Hospice in the Central Massachusetts region. She is licensed as both a Nursing Home Administrator and Assisted Living Administrator in the state of Rhode Island, where she most recently functioned as Executive Director at Brookdale Cumberland, a 138 unit CCRC. Prior to entering into Assisted Living in 2014, Jessica served as Executive Director with Life Care Centers of America in Rhode Island and Massachusetts beginning in 2008. She joined the Notre Dame Health Care team in her role as Executive Director of du Lac Assisted Living Residence in 2017.

Emmanuel Ikomi, LNHA
Executive Director/Administrator
Notre Dame Long Term Care and Rehabilitation Center

Emmanuel is a graduate of UMass Boston and holds a B.A.degree in Human Services Advocacy and Healthcare Management. He is a Licensed Nursing Home Administrator and has managed several nonprofit organizations serving seniors in Independent Living, Assisted Living, Rest Home and Skilled Nursing Home environments. His work at the New England Home for the Deaf provided him with the unique opportunity to learn American Sign Language as well as the culture of the deaf and deafblind community, experiences which have shaped his philosophy for individualized care for the whole person and knowing your residents’ past hobbies and interests. Additionally, Lucy, his Miniature Schnauzer service dog who has been part of his unique management approach for the past 11 years, joins Emmanuel at Notre Dame Long Term Care and Rehabilitation Center. She helps him form relationships with staff and residents with her compassion and ability to read the emotions of the moment whether in meetings, greeting visitors, residents and interacting with staff. Our residents, visitors, and employees have responded positively to her therapeutic presence. Their unique style has enhanced the mission of Notre Dame Long Term Care and Rehabilitation Center.

Paige Thayer
Director of Development & Philanthropy

Paige holds a B.A. in Communications from Norwich University, and has had a long career in non-profit fundraising and donor relations in both large and small organizations, including human/social service, and academia. Her experience includes development and fundraising, marketing and community relations, special events, and project management.



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