Loree Tamayo


Loree has thirty years of experience in healthcare. She has been in business since 2009, helping many startups or struggling healthcare facilities become profitable businesses. Much of her experience has involved planning and opening new facilities and agencies. She started her career as a nursing facility administrator and worked in almost every healthcare sector, from long-term care to acute care. In 2018 she started her most notable career success as a CEO of a rural hospital while continuing to run her successful business. She turned a financially strapped hospital district into a profitable and viable health system in three years. She has since returned full-time to her business, where she helps companies in urban and rural areas run successful healthcare businesses.

Chantelle Julian

Director of Business Development

Chantelle has a Bachelor of Arts degree in Social Work from Baylor University with experience in administration and management of Assisted Living, Nursing Facilities, and Adult Day Health. Chantelle also has a strong background in Case Management, having worked in Oklahoma and Texas, providing Case Management services in hospitals and geriatric settings. Chantelle’s passion is working with and assisting people from all walks of life, and she has found that healthcare provides a unique opportunity to do just that. She has worked for LTCM for over 11 years and has over 30 years of experience in healthcare.

Melanie Gagliardo

Director of Operations

Melanie Gagliardo has been a nurse specializing in geriatrics for over 25 years. Melanie is a certified consultant for CHAP (Community Health Accreditation Program) and ACHC (Accreditation Commission for Health Care). Melanie specializes in all aspects of operations, including budget development and compliance, market analysis, strategic planning, staff management, education, training, quality assurance, performance improvement, policy and procedure creation, adherence, reporting, contract facilitation, and regulatory compliance.
Melanie has started and managed countless assisted living and memory care communities and home health and hospice agencies from inception to successful operation. Melanie is passionate about the senior population and focuses on education, best practices, and quality-of-life initiatives in conjunction with regulatory compliance. She has developed numerous programs to facilitate the growth and development of employees from front-line staff through upper management. Still, she believes the number one priority for every facility is a genuine relationship with those we serve. Melanie attended the University of Florida, and before joining LTCM, her nursing career included internal medicine, pediatrics, home health, and hospice. Melanie resides in San Antonio with her husband and two sons and enjoys all things outdoors, cooking, reading, and fostering abandoned animals.

Lisa Gonzales

Healthcare Consultant

Lisa has more than 30 years of experience in senior care. She earned her BA in Psychology from Angelo State University and Masters in Gerontology from Abilene Christian University. Before joining LTCM, Lisa had the privilege of serving in various capacities, which included: director of an independent assisted living and adult day health communities, administrator of licensed nursing facilities, a specialist with Adult Protective Services, researcher/grant writer for acute care and non-profit organizations and serving on many non-profit boards.

Sue White, RN

Healthcare Consultant

Sue White is an RN Healthcare Consultant with over 35 years of experience as a registered nurse. She obtained her BSN from Bowling Green State University in Toledo, Ohio. She has spent most of her career in Home Health and Hospice Care, focusing on quality performance improvement and compliance consulting and management. Sue specializes in managing and consulting nursing facilities, assisted living, home health, hospice, and rural hospital districts. She ensures quality start-up, ongoing operations, and compliance with all regulations, policies, and procedures. Sue resides in Spicewood with her husband and enjoys gardening, decorating, baking, and reading.

Sarah Castaneda LVN, CMAC

Nurse Consultant

Sarah has over 15 years of experience in geriatrics, including over eight years of MDS experience. She earned her LVN License from the Victoria College Zelda L. Allen School of Nursing in 2015. Sarah has an extensive MDS background and specialty knowledge in Case-Mix. She has maintained up-to-date knowledge of PDPM, the PASRR process, rules, and regulations, and developing and maintaining care plans. Sarah most recently has been working with LTCM’s Total Case Management Program in multiple PPS and Critical Access hospitals. With Sarah’s clinical background, she has been an integral part of the LTCM Case Management team. Sarah resides in La Grange, Texas, and enjoys spending time with her husband and three children.

Andrea Freitas

Healthcare & Business Development Consultant

Andrea Freitas is an experienced leader in the Senior Living and healthcare industry. She has over 30 years of management success in Long Term Care, Assisted Living, Acute Hospitals, Home Health, and Hospice. Andrea began working with LTCM in January 2022. She has been an asset to LTCM’s Case Management team working with several rural hospitals implementing LTCM’s Total Case Management program. Andrea is a native Houstonian and mother of four who attended LSU for her Bachelor of Business Administration. She enjoys cooking, reading, and traveling when she is not working. Andrea started in the healthcare industry because of her passion for helping others. She also believes nurturing and enriching our healthcare workers’ lives results in better quality care.

Cassi Centers, RN

Healthcare Consultant

Cassi Centers has 23 years of experience in geriatrics and long-term care. She is a Registered Nurse with ten years of leadership experience as a Director of Nursing, which includes the successful management of a 22-bed ventilator unit and experience as a multistate traveling Director of Nursing and Consultant.  Cassi joins LTCM with well-established knowledge in the oversight and management of nursing departments, including Regulatory Compliance, Quality Assurance, Quality Measures, and QIPP.  She has a strong background in education, training, and mentoring.  

Lacey Virgin

Case Management, Benefit Coordination and Utilization Review Consultant

Lacey has 17 years of experience in healthcare. She started serving her community in 2006 as a Certified Medical Assistant in a physician’s office, where she performed front and back-office tasks for multiple specialty physicians. Lacey has been with LTCM since 2022, focusing on using effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to promote cost-effective medical outcomes and assure our patients receive appropriate levels of care. Lacey has a passion for helping her community and takes pride in being able to provide her services within the healthcare community.

In 2018, Lacey earned her associate degree in business management and moved to Central Texas in 2019 from Colorado. She has four children and a grandson. She enjoys spending time with her family and traveling with her husband.

Jacy Crim

Marketing Consultant

Jacy has a background in full-service marketing for healthcare facilities, agriculture, and small businesses. She has experience in digital marketing strategies, content creation, video production, and event planning, to name a few. She attended Missouri Valley College and double majored in Marketing and Public Relations. She helps consult, train, and manage LTCM clients’ social media accounts to increase visual aesthetics, increase following, and target market desired clients. Jacy resides in Missouri and enjoys spending time with her family, walking with her dogs, and cooking.