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In the end, it appears to have come down to money – hardly unusual in business, especially one as competitive as health care. Initial reports suggest that while Kaleida Health remained profitable, the margins were too thin for comfort and so, on Friday, the hospital system’s board cut James R. Kaskie loose.

We don’t know the ins and outs of the action well enough to conclude that the board was right or wrong in ousting its chief executive officer, but we do know this: Kaskie brought many talents to bear and he left Kaleida in better shape than he found it. He did some fine work as head of Western New York’s largest hospital system, positioning it strongly for a future at the heart of the burgeoning Buffalo Niagara Medical Campus.

Indeed, the development of that campus is Kaskie’s lasting legacy. Unlike many leaders in health care, Kaskie embraced the order of the state Commission on Health Care in the 21st Century to close Millard Fillmore Hospital at Gates Circle, which in fact had been a goal of Kaleida for several years.

But under Kaskie’s leadership, Kaleida took advantage of that decision to help build the Medical Campus rising up around Buffalo General Medical Center and Roswell Park Cancer Institute.

The new Gates Vascular Institute took root there as the Gates Circle hospital closed and soon, so will the John R. Oishei Children’s Hospital, successor to Women & Children’s Hospital at Elmwood Avenue and Bryant Street.

Kaskie also embraced the opportunity to collaborate with Erie County Medical Center through a new corporate structure known as Great Lakes Health, of which he was also named CEO. He helped guide the new entity into being, a massive undertaking, though the Kaleida board was evidently dissatisfied at the pace with which closer ties between Kaleida and ECMC were being pursued.

Such is the nature of health care. Few leaders of hospital systems stay in place as long as Kaskie, who was recruited to Kaleida in 2004 and was named its president and CEO two years later. Tellingly, no one interviewed for Saturday’s News stories about Kaskie’s ouster had anything negative to say about him – not union leaders, not a former board president, no one. That also is unusual in any large and complex organization, but it is a mark of Kaskie’s collaborative leadership style and an approachable nature.

Whatever the reasons and consequences of Kaskie’s departure, the good news is that the board has selected an eminently qualified and successful individual as interim chief at Kaleida: Jody Lomeo, the low-key but effective CEO of ECMC. Under his leadership, that hospital not only has forged links with Kaleida, under the Great Lakes Health umbrella, but has developed into a smoother-running operation that is expanding and modernizing.

For now, he will lead both organizations and he is clearly the right choice for that challenging task. While the appointment is interim, it would be surprising if his name wasn’t already near the top of some lists as Kaskie’s formal successor.

We wish both men well.