When Paul Blom and his husband, Bob White, started Right at Home 15 years ago, they knew just the kind of culture they wanted to build.

And like many other companies that have grown — to about 200 employees in Right at Home’s case — CEO Blom has had a strategy to keep that start-up culture alive.

“You have to remember that everything you do touches everyone you know,” said Blom, whose company ranks No. 1 on the Top Workplaces list of midsize companies. “When the caregiver has this fantastic experience, they tell their clients about it, who then feel even more optimistic about using our services because the client knows we are taking good care of the caregiver.”

Blom also tries to foster authenticity in the workplace: no surprises, no pretending.

Most of the Bloomington company’s staff works outside the office, providing one-on-one care to clients. But Blom believes small gestures like handwritten cards celebrating birthdays, welcoming new employees and group events, such as the annual company outing to the Chanhassen Dinner Theatres, help make them feel appreciated and welcome at headquarters.

“For me, authenticity is being true to yourself,” said Blom, whose company has been on all seven of the Star Tribune’s Top Workplaces lists.

“I make no apologies or attempts to hide the fact that Bob and I are married,” he said. “Everything we do is about being entirely who we are. It’s not like we have signs that say we’re gay, but it’s very clear to people. And that allows people to be comfortable being themselves in their own ways.”

For Bluestone Physician Services CEO Todd Stivland, flexibility has been key to keeping the office atmosphere the same as when it was a one-man band.

Since its founding in 2006, the Stillwater company, No. 2 on the list of midsize companies, has grown to about 185 employees. Yet despite its size, Stivland said, Bluestone likes to keep it loose. There is no start or end time to the workday, and people can work on a schedule that fits them best. Doctors and nurses don’t worry about hierarchy and are treated as equals.

Bluestone’s flexibility relies on the kind of people who walk through the door, Stivland said. New hires should bring an attitude that matches the company culture, or it could be a deal breaker.

“We trust the people who work here,” he said. “On the flip side, if people aren’t holding up their responsibility and aren’t bringing in a positive attitude to the workplace … we aren’t afraid to tell people they can’t work here unless they can change that.”

While most organizations struggle to maintain the culture they start out with, Stivland said the goal became easier as more people joined the roster. Staff, especially those who have been around a long time, reinforce the culture themselves. It has ­naturally become a shared responsibility.

“People who’ve been here a long time are stewards of that feeling,” Stivland said. “If someone brings in a lot of negative energy or a toxic attitude, the long-term staff are pretty quick to pull them aside and say, ‘I like this job, and I don’t want to be treated this way at work and I don’t want an atmosphere like this.’ ”

Eric Malmberg, broker/owner of RE/MAX Advantage Plus, the No. 4 company on the midsize list, thinks workers should be able to get something meaningful out of a workplace.

He thought hard about a quote from Oscar Wilde when he founded his company: “Success is a science; if you have the conditions, you will get the result.”

Given the quickly shifting landscape of the real estate industry, he believes that his employees want to be challenged and grow as professionals.

“That’s the missing element in our business,” Malmberg said. “Most brokers are always in react mode in terms of educating themselves, and we try to be much more proactive.”

Malmberg thinks that his strategy of investing in his employees has helped attract some of his top associates and keep them around.

“We provide the best overall value to the marketplace,” he said. “To attract the most successful associates, you have to have the best technology, the best facilities and the best training.”

Mike Lescarbeau, CEO of Carmichael Lynch, also adds teamwork to his list.

When he took over the helm in 2007 at Carmichael Lynch, which ranks No. 10 on the Top Workplaces midsize list, the company was going through “a lot of upheaval.”

Upon arrival, he found departments that competed against one another and refused to work together. Morale was low amid the recession, and turnover was around 20 percent, which is par for the course in the hyper­competitive ad industry.

He wanted to completely overhaul the culture and make people value collective achievements as much as their own personal goals. To do that, Lescarbeau got rid of the divisions between departments and individual financial responsibilities. Nine years later, he says he was successful at uniting the branches of the company.

“There’s an enormous amount of support that our people feel from each other, and that is unusual,” Lescarbeau said. “I’ve been at nine ad agencies in my life, and I’ve never seen one quite as healthy.”

Given the competitive nature of his employees, the challenge for Lescarbeau was maintaining the reputation that they’re “winning” while making sure they feel fulfilled by their work and not exhausted by it.

Lescarbeau also adds to the thoughts of Blom, Stivland and Malmberg that one key to maintaining a workplace culture is hiring people who will embrace it.

“We hire the kind of people who get a lot of fulfillment from feeling like they’re doing some of the most creative work of their careers here,” Lescarbeau said. “That means a lot to our people.”