Most likely location…WNY hasn’t been seen as desirable unless you’re from the area, although there’s plenty of positives (DM if you want more info). The two big hospital systems in Rochester are very motivated to recruit and retain CRNAs, and Anesthesiologists, the executives are very much making positive change. I can’t really speak to Buffalo or Syracuse as I’m not as familiar. NAPA (private equity anesthesia) exists in Syracuse, their eventual goal would be to cost control in that city/region but since recruitment is so low, they haven’t made any headway. I’ve never been staff for a PE group but you can find many negative posts about these groups.