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The resignation of James R. Kaskie as chief executive officer of Kaleida Health comes at a time when the long-sought vision of a downtown medical campus in Buffalo is becoming a reality.

Kaskie played a central role in that achievement, and it will likely be his legacy here.

“He did an amazing job in bringing together the disparate parts of the health care community,” said Edward F. Walsh Jr., a past president of the Kaleida Health board of directors.

Kaskie was recruited to Kaleida Health in 2004, and was named president and chief executive officer in 2006. In 2007 he also was named chief executive officer of Great Lakes Health, the parent organization of Kaleida Health and Erie County Medical Center.

Colleagues and observers of the region’s health care industry say Kaskie was a very competent CEO and a well-liked individual known for his friendly demeanor. Until recent times, they say, he successfully navigated Kaleida Health through a highly competitive business in which there is little financial margin for error and intense pressure to deliver results.

“It’s one of the most difficult jobs out there,” said Walsh. “You have to balance on shifting sands, and there are things you don’t have control over.”

Kaskie led the region’s largest hospital system during a tumultuous period of change.

In 2006, the state Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission, ordered the closure of Kaleida Health’s Millard Fillmore Hospital at Gates Circle as part of an attempt to restructure the state’s inefficient health system.

Kaskie and others in the community saw the commission’s conclusions as an opportunity to create a new vision for health care delivery that included the 2008 agreement between Kaleida Health and ECMC to operate separately but align their services under Great Lakes Health. That agreement paved the way for major changes in hospital care in the region.

“He embraced the notion of collaboration, most obviously seen with ECMC,” said William Joyce, another past board chairman who helped recruit Kaskie.

“He was the right person at the right time,” said Joyce, recalling that Kaleida Health had just gone through a financial turnaround and needed someone with detailed operational expertise.

Kaleida Health in 2012 closed the Gates Circle facility, and moved its services and staff to the medical campus – mainly the new $291 million Gates Vascular Institute next to Buffalo General Medical Center. The joint project with the University at Buffalo consolidated Kaleida Health’s heart, stroke and vascular services, as well as ECMC’s heart services. The building also houses the University at Buffalo’s Clinical and Translational Research Center, and includes an institute to test new medical products and bring them to market.

On a larger scale, the project was the first tangible result from the state-ordered consolidation of Kaleida Health and ECMC, and a major indication that something significant was happening on the fledgling medical campus.

At the time, Kaskie described the move of Gates as the most complex project of his career.

“We’re taking two organizations and making them one, changing the landscape for doctors and staff. That creates job uncertainty,” he said.

Dr. L. Nelson Hopkins, III, president of the Gates Vascular Institute, praised Kaskie for his efforts to build up the medical campus downtown.

Other medical campus projects built or started during Kaskie’s tenure include a new $237 million Women & Children’s Hospital, a new $375 million medical school for the University at Buffalo, and a $64 million nursing home, HighPointe on Michigan, that replaced the outdated Deaconess Center on Humboldt Parkway and the skilled-nursing unit in Millard Fillmore Hospital.

UB does not have a hospital of its own, and proponents of the projects see them as integral components of a vision to strengthen ties between UB and Kaleida Health to create the academic medical center Buffalo has lacked.

“Jim did a wonderful job of setting the stage for Kaleida Health to become a great health system,” Hopkins said.

Kaskie, who could not be reached Friday to comment about his work or the resignation, also played key roles in the consolidation of services with ECMC, including the organ transplant program and behavioral health services.

The construction, closures and service changes would be difficult under the best of circumstances. They also took place as Kaleida Health responded to massive changes in the health care system, including pressure from insurers to control costs and passage of the Affordable Care Act.

“Jim accomplished a lot in a very tough business to manage. But the most significant thing about him is that he is a really good person – very ethical and moral,” Joyce said.

He and others described Kaskie’s management style as tireless but inclusive and collaborative. Even those who, at times, disagreed with Kaskie found him to be a likable person.

“We had different approaches and had our fights over what is best for health care in Western New York,” said John Klein, former president of CWA Local 1168, which represents many of the workers at the hospital network.

“But Jim was approachable and someone who could work through issues,” he said.

Kaskie previously worked as senior vice president for operations of Denver-based Catholic Health Initiatives, one of the largest non-for-profit health care organizations in the United States. A native of St. Louis, he earned a master’s of health administration and a bachelor’s in history from Saint Louis University, and a master’s of business administration from Xavier University in Cincinnati.

Kaskie’s CEO tenure lasted much longer than most in that position. Underperforming finances, in the end, appear to have been the main reason for his departure, but the desire for a leader with a different style may also have played a role.

“Part of this might just be the cycle and dynamics you see in this business,” said Joyce, a close friend. “Institutions reach a point where there is value in getting a new blood and perspective.”

email: hdavis@buffnews.com