Tote replaces Leza Wainright who announced she's retiring last week.
The shakeup follows continued problems at the Cherry Hospital state mental facility in Goldsboro which has been repeatedly cited by federal regulators.
They yanked the hospital's certification in 2008 after a patient choked to death while left unattended for nearly a day without food or water. Without certification, Cherry lost federal funding.
The hospital regained certification last summer, but was once again cited earlier this month after employees allegedly used improper force with a patient.
Contacted by the ABC11 I-Team Tuesday, state officials did not say Wainright's retirement was related to problems at Cherry Hospital.
In his memo, Secretary Cansler praised her leadership and 32 years of service to the state.