Emerald Health Services

* Los Angeles

* 2007 revenue: $61.2 million

* 2006 revenue: $54.3 million

* Compound average annual growth rate: 93%

* Founded: 2002

The demand for healthcare professionals is fueling growth at Los Angeles-based healthcare staffing firm Emerald Health Services, says CEO Mark Stagen.

"Obviously there's a huge demand for healthcare professionals, we're in a great industry," Stagen says.

There's also the people and the company's culture.

Stagen says Emerald has three clients - nurses, hospitals and corporate employees. And the company works to take care of all three.

Its hard work led Emerald to the Number 6 spot on Staffing Industry Analysts' list of fastest-growing

U.S. staffing firms.

The company provides travel nurses and does some executive search as well. Stagen founded Emerald in 2002 after reading about the shortage of nurses; he had previously been with a broadband engineering firm.

"I just recognized there was a need," he says. "Whenever you have a great industry, there's always room for one more company."

Stagen received the Ernst & Young Entrepreneur of the Year award in 2007 in the business services

category in the Los Angeles area, and was one of the finalists for the national awards as well. This year, Stagen is one of 12 judges for the Ernst & Young Entrepreneur of the Year award.

He is also a founding member of NATHO - the National Association of Travel Healthcare Organizations

-a new organization designed to help bring the industry together.

Healthcare staffing appears to be countercyclical, faring better in slower economic times. Stagen says the company hasn't been hit by the economic slowdown.

And right now, the company is small. "We still have plenty of opportunities and plenty of room to grow," Stagen says. As for Emerald's future, Stagen says the plan is to do more of the same and keep growing the company.

"I'd love to be the largest travel nurse company in the country. I think that would be great," he says.

The Delta Companies

* Dallas TX

* 2007 revenue: $40.8 million

* 2006 revenue: $25.3 million

* Compound annual growth: 92%

* Founded: 1997

CEO Jeff Bowling was coaching college baseball when he was recruited into the staffing industry. That was in 1996. He purchased the company (then a $4 million firm) in 2003, changed the name and is now leading one of the top 10 fastest-growing U.S. staffing firms.

The Delta Companies provide permanent and temporary physicians and allied healthcare professionals through five companies: Delta Physician Placement, Delta Allied Placement, Delta Locum Tenens, Delta Flex Travelers and Liquid Medical Recruiting.

Bowling attributes growth to "the industry wave that we are riding - the demand is never-ending" and "the retention of great people internally." The company has been on the list all four years, and moved up to the number 7 spot from number 10 in 2007, number 17 in 2006 and number 21 in 2005.

Delta continued to ride this wave in 2007 as well, with accelerated growth in travelers and locum tenens, especially in the areas of specialties within emergency medicine, hospitalists for locums and within pharmacy on the travelers side.

Marc Bowles, chief marketing officer with Delta, says the company is tracking just under $60 million for 2008. In terms of what worked well for the company in 2007, it was a combination of keeping both customers and internal employees happy. Delta's management knows that happy employees lead to happy customers.

"We realized that a huge piece of our retention was in educational offerings - from finance to health, wellness and spiritual things," Bowles says. "We looked at the market and realized that we are not only competing with the staffing companies in Dallas, but with the entire Dallas market. So in order to do that, we had to raise our benefits up."

Delta is offering matching 401(k) contributions to its employees. The company also provides its employees a defined career path so the employees know where they are going to be in six months to a year within the company.

Of course, another element is an emphasis on the customer experience and learning from the customers what the company can do to enhance their experience and how Delta can improve its service offerings. "So it was a nice well-balanced approach in looking at what our employees needed and what our customers want," Bowles says.

Medical Solutions Inc.

* Omaha NE

* 2007 revenue: $30 million

* 2006 revenue: $18 million

* Compound annual growth: 86%

* Founded: 1997

It was 2006 when Scott Anderson and his partner, Dale Williams, read the writing on the wall about healthcare staffing and decided to sell their information technology staffing business to focus on travel nurse staffing. While it was pretty clear to them that healthcare staffing is where the growth is, the two made sure that they didn't just ride the wave - planning ahead was critical for them.

"My personal background is in banking and finance," Anderson says. "As a result, we have a very strong financial picture and budget. We always have a five-year pro forma looking outward and obtaining those goals."

The company also keeps its focus in terms of its service offerings and expands its repertoire only after mastering one set of specialties. By the end of 2007 it branched out into allied and international recruiting.

Although international recruiting for nurses is a tough business right now, with no visas available to bring them into the United States, Anderson views this as an investment for years to come.

"The truth of the matter is that there is a fraction of regular nurses who are going into traveling. With our growth, what we are doing is that we are taking from our competitors," Anderson says. "After a point we are going to need to get outside supplementation for nurses. About 20% to 25% of our nurse flow is going to be coming from overseas. So we have a few years to get our act together on the international side."

Another strategy that has worked for Medical Solutions is hiring like-minded people that will fit well into the company culture. And what is the culture?

"We have a full-blown break room with foosball table, card table, plasma screen TV," Anderson says. "We have foosball tournaments all the time. We have barbecues outside that we use, and we are dressed casual. We have a full-time concierge on the staff who does nothing but handle the personal affairs of the staff - from picking up dry cleaning, returning things to Wal-Mart, getting your tags renewed. We go out on monthly outings, and we do this during work hours. We do a lot of celebrating and fun in the office.

"The culture of the company is one that is exciting and appreciative," Anderson adds. "We have an environment that works really well with honesty and integrity at the cornerstone of it for a person who likes a very lively environment."

The company also offers its employees a chance to try out their more creative skills. Medical Solutions is doing a campaign called the "Restless Nurse Syndrome," which is a fake, comic documentary that portrays the life of a travel nurse. It's a marketing campaign to create brand awareness. And all the actors and producers are employees of Medical Solutions.

The strategy appears to be working. With about 106 internal employees, the company has so far lost only three people voluntarily in the past four years.

Methodology

The ranking is based on compound average annual growth between 2003 and 2007.

Revenue was adjusted for acquisitions. Information on revenue comes from the companies

themselves and was provided during a survey that took place earlier this year. Participating

companies making the final list were required to submit financial statements.

What works:

* Seeing a need

* Developing culture

* Retention

* Planning

* Foosball