Good People

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Former CEO discusses the world of hospice and the soul of Shepherd’s Cove

Story and photo by David Moore

On Oct. 9, 1989, Rhonda Osborne went to work as the first full-time, bedside nurse at Shepherd’s Cove Hospice. Four years later she became nursing supervisor for the non-profit agency, then served 27 years as its CEO before retiring March 1.

That’s 32 and a half years of directly or indirectly assisting people during the final days of their life’s journey.

It’s now the second week of March and for a moment Rhonda looks a little lost sitting in her comfortable living room in Albertville.

“What was it … 10 days ago I retired? Nine? I heard,” she laughs, “that you can’t keep up with time when you retire.”

She and her husband Ray were thinking of rescheduling a Mediterranean cruise they had to cancel back in 2001 because of the 9/11 attacks. Now they’re holding off because of Russia’s Ukrainian invasion.

“But we don’t have to be in hurry,” says Rhonda, who has been toying with a tentative to-do list. Closets need cleaning, but what’s the rush there? Maybe she’ll start playing piano again. She enjoyed it in high school. Certainly, she’ll keep singing in the Albertville First United Methodist Church choir, but other than that …

“I have not fully wrapped my brain around not having a work schedule,” says Rhonda.

When she first went on the work schedule at the then seven-year-old Hospice of Marshall County, the limited staff was licensed to provide only homecare.

Under Rhonda’s direction, the agency built a 10-bed inpatient unit, offices and community room, changed its name to Shepherd’s Cove Hospice. Now, with a staff of 90, at any given time it cares for 85-110 terminal patients and their families in nine counties, totaling 600 patients last year.

“Since 1995, we’ve served just over 14,000 patients in hospice programs,” Rhonda says. “And the concentric circles of impact expand to at least a family member or friend, sometimes 10 to 20 of them.”

To that, one can add the annual impact of grief counseling that reaches 300 children in 64 schools across four counties, plus another at least 200 adults.

Fair to say that, so far, a big part of Rhonda’s retirement has been catching her breath.

Rhonda’s early life had a Mayberry aura to it.

“Opie and I are about the same age,” she says.

She grew up in the county, New Harmony, a “suburb” of Asbury. She and her sister Deborah picked cotton on her dad’s farm until second grade when he bought a cotton-picker machine. She thought that would get her out of the hard, sweaty work, but he then sent them to work their uncle’s field.

In her spare time, Rhonda not only learned to play piano, she also gave lessons to other kids.

“It was not my gift,” she confesses. But singing at churches was, and by eighth grade she was performing solos. Later she sang in Jacksonville State University’s Baptist student choir.

About 20 years ago, Rhonda sang solo during a Hospice memorial service at Boaz First Baptist.

“Afterward, I saw my old piano teacher from, like, one hundred years ago and apologized for not sticking with piano,” she laughs. “She said, ‘I see you learned something.’”

Andy Griffith’s TV comedy downplayed it, but death was a real aspect of county life back then. And it influenced Rhonda.

“Living out in the country in the ‘50s and early ‘60s, funeral rituals were different than now,” she says. “People died at home. Bodies were brought home. I was exposed to that as a child. Death was a part of life.”

As a ninth grader, she once sat with her ailing grandmother, who was sleeping on the couch. Rhonda knew she was ailing but didn’t know she was dying.

“She suddenly raised her arms and said, ‘It won’t be long, I’m coming. I’m coming,’” Rhonda vividly recalls. “I thought she was dreaming.”

Her grandmother died a few hours later.

“I have seen that repeatedly with patients,” she says. “But I had that exposure to death growing up, and it helped shape me. Hospice was not as frightening to me as a nurse as it might be to some folks.”

Another aspect of childhood affected Rhonda’s career path.

“I wanted to be a nurse since third grade when I got a nursing kit with a Red Cross arm badge,” she says. “I never wavered. I always wanted to be a nurse.”

Determination led her to a nursing degree from Jax State. In 1977 she graduated, married, moved and became a night-shift nurse at Redmond Park Hospital in Rome, Georgia, earning $4.56 per hour.

“I thought I’d hit the jackpot,” she beams. “I was licensed in a few months and got a 50-cent raise.”

One day over lunch with Dr. Gerald McCormick, an oncologist, they discussed the guilt they felt over putting cancer patients through futile treatment. He mentioned a relatively new concept – hospice – that enabled the terminal to die at home with compassionate care. The idea drifted from England to the United States during the 1970s and, in 1982, was legislated for Medicare coverage.

The need for such care was furthered

SNAPSHOT: Rhonda Osborne

EARLY LIFE: Born 1955 in the old Albertville infirmary to Mack and Elowayne Slaton, both deceased. Older sister Deborah.

Grew up in the New Harmony on Sand Mountain. EDUCATION: Attended elementary school at the old Whiton Junior High in DeKalb County and Asbury Jr. High. Graduated Albertville High, 1973; earned nursing degree from Jacksonville State University, 1977. FAMILY: Married a Georgia man, Gary Floyd, 1977; divorced 1989 and moved back to Albertville; two grown children:

Jarrod Floyd of Rome, Ga. (wife Melanie; children Mac, 11, and Jay, 8); Anna Floyd of Albertville (children Bryson

Shelton, 19, and Kade Shelton, 18). Rhonda married Ray Osborne in 1998; owns Cook and Sons Ace

Hardware, Albertville; daughter Jo Ellen Jordan of Albertville has two grown children: Matthew Boomershine, 31, (wife, Rachael, daughter, Addeline, 1); and Mary Katherine Boomershine, 29. CAREER: Rhonda was an RN at Redmond Park Hospital in Rome, Ga., 1977-1989; broken by two years of community health work; worked three months in an Albertville doctor’s office; then was hired as Hospice of Marshall County’s first full-time bedside RN, October 1989; nurse supervisor, 1993; CEO of what would become Shepherd’s Cove Hospice, 1995; retired March 1, 2022. INVOLVEMENTS AND AWARDS: Member of Albertville First United Methodist Church; sings in the choir; Albertville Rotary;

Polly Clark Award from the Alabama Hospice and Palliative Care Organization after serving as president for two years, 2010; inducted into the Albertville High School Hall of Fame for her hospice work, 2013; Director of Year for

National Philanthropy Day by the Association of Fundraising Professionals; named Paul Harris Fellow in 2018.

sharpened for Rhonda when her 55-yearold father died of colon cancer in 1980.

Rhonda divorced in 1989, returned home, worked in a doctor’s office a few months then hired on with Hospice of Marshall County, which was formed in 1982.

She soon met her first homecare patient, who lived north of Arab in Oleander.

“We had not been there long at all before I knew I loved it,” Rhonda says. “This was what I wanted. I saw hospice to be a type of nursing where I could also teach and educate patients and families. I quickly developed a trusting relationship with patients so I could give them hard, difficult information and still have them trust me to guide them down that end-oflife journey.”

Rhonda could see relief on patient and family faces as she helped them understand what would happen, that there was medication for symptom relief, the supplies they needed – and that she could teach loved ones to provide this care.

One family rejoiced aloud when she arrived: “The cavalry has arrived!”

“I could see the relief on their faces just knowing they did not have to do this by themselves anymore,” Rhonda says. “They did not have to face it alone.”

In 1995 Rhonda was named CEO of Hospice of Marshall County. The staff grew to 50 who were caring for 70 home patients.

With a growing need for inpatient care, in 2001 she and the board began exploring the construction of Shepherd’s Cove. With the opening of the new 10bed facility in 2006, the agency now provided homecare and inpatient care. Hospice always admitted those with no insurance to pay for care, but the recession of 2007-09 increased the numbers. During the ensuing economic hangover, Rhonda and the board decided to open a thrift shop in 2011 as a new revenue stream.

“I didn’t even know how to do this,” she says. “Few hospices nationally did it, but I got ideas, and within three months we had a location and an owner who helped pay for renovations and gave us two months free rent. We got a household of contents donated from a family estate and pickup trucks donated for hauling.

“The Lord basically gave us all we needed. We were going gangbusters from day one.”

The thrift shop continues, having expanded into its fifth location in Beck Plaza near the Boaz city limits.

“People are great to give donations,” Rhonda says. “It has definitely allowed us to provide programs that are not reimbursed.”

In 2017, with the agency now serving patients across Northeast Alabama, Marshall County was dropped from the name, and it became Shepherd’s Cove Hospice. 1. It must take a certain type of person to work at Shepherd’s Cove. How can the staff do what they do, day after day, without falling into depression?

It’s kind of cliché: “It takes a special person to do hospice care.” Early in my career I discounted that, but the longer I was in hospice, I realized that, yes, it does take a special person. It takes someone comfortable in their own skin and with their own mortality. Someone willing to teach and be with person after person who is on the end-of-life journey.

Caregivers find ways to cope. For some, it’s their faith. Coping should include physical exercise, laughter, enjoying their own life.

One thing Shepherd’s Cove does well is providing an internal support system so staff can talk about their hard times with patients, give encouragement to others, get to vent. Sometimes coping leads to more training.

Another way we support staff … say, our bereavement team talked to Mrs. Smith, and she called out a certain staff member for doing something well. We pass that on. Give people a pat on the back and let them know they made a positive difference to someone.

Staff that stay in hospice learn to accept that life is short for many people and take the attitude that, “If I can just make it better for them today, I can keep doing this. I can keep going on.”

The national burnout average for a hospice nurse is two years, but a lot of our staff have been there five years and more. Shepherd’s Cove has always been pretty good at holding onto people, keeping them longer than some other areas do.

But handling the emotional side of the work is still a personal adaptation.

I was always blessed by the patients. I learned so much from them about how to live. And how to die. 2. Requiring the services of Shepherd’s Cove Hospice for a loved one is a tragic time; nonetheless, it seems one seldom if ever hears negative comments about their experience with the agency. What do you attribute that to?

We don’t get a lot of complaints. I think it’s because we put a lot of time into staff development.

We start from the very beginning with the attitude that we are there to be servants, to treat our patients as we would want our families treated. We begin on day one training staff with that mindset – serving with a servant’s heart.

We have a philosophy that we treat every patient as we would want our own family treated. We try to ensure the personal values of all potential employees – and our volunteers – match our agency values.

We have a set of values and talk about our culture. One value is reverence. It’s a hospice requirement to provide spiritual support. The regulations come from Medicare and insurance. Our regulations are in the Social Security Administration law.

Spiritual support is not forced, but it has to be addressed and provided if desired. Our staff is not there to evangelize. We’ve taken care of all faiths, including those of no faith. We even once had satanic worshipers.

Under my leadership we developed a value of reverence – acknowledge that there is a higher power. Different faiths might not call the higher power “God.”

We do identify God as the higher power. It is not uncommon for us to have prayer in our staff meeting or for there to be prayer requests. But none of that is forced on staff or our volunteers. But before they’re interviewed, they have read and signed off on the values.

Another factor in keeping down complaints is training. You can imagine that someone who has been told they are terminally ill might want to kick a dog, so to speak. You can imagine the

emotions that someone in hospice might have. Or you have been told by someone your loved one is dying.

We are not perfect. Sometimes patients and their families have complaints about care. We train the staff to listen to them. You validate what they are saying. If it’s important enough for them to be calling about a concern or complaint at 3 o’clock in the morning, it’s important enough for a supervisor to hear about it at 3 o’clock in the morning.

We look at all complaints, valid or invalid. Some complaints might be based on something we do that’s required by regulations. If that’s the complaint, I’m sorry. I can’t do anything. But if the complaint is about the personality of someone on staff, or if we made a mistake, we address it really fast.

Maybe you don’t hear about complaints in the community so much because we hire people who have a mindset of servitude, and we listen to complaints, take them seriously and address them promptly. 3. What were the biggest challenges you faced in your years at Shepherd’s Cove?

The biggest challenge was building the inpatient unit. I had “built” a house before, but this was huge. Building that size building threw me into a world totally out of my comfort zone. From fundraising to developing contacts in the political world, from the legislature to the governor’s office.

I was making presentations and writing a 100-page federal grant documents and our certificate of need. I found later you hire an attorney to do some of those things. There were so many obstacles that someone smarter than me would have reached out to attorneys.

But I thought I was supposed to do it, so I did it – with God’s help, fortunately, and a lot of people along the way, including Ray Osborne.

Ray had a hardware store and previously had a construction company, so he was able to guide me in a lot of that. He also knew people I didn’t know, and introduced me to people I needed to know who became friends.

Still, learning about prep sites, red iron and having to pick out things such as every door in that building and whatever kind of hardware it needed … that was a challenge. Along with dealing with architects, construction people, plumbing, electricity, HVAC and more. Some of the framing went up just before Hurricane Katrina storms hit and blew some of it over.

And when it was finished, I had to open a unit that operated on a concept that was brand new to the area. Ray and I visited inpatient hospice units in several states trying to glean their knowledge.

It was not totally my job – certainly I incorporated my board of directors, as I needed to do – but the bulk fell on me.

That entire process – from the time the board decided to build the unit and administrative offices to the time we moved in – was five years.

I tried to convey to the architects what we wanted. I wanted it to be a place of tranquility. I did not want people to drive by and say, “That is where you go to die,” but rather to say, “When I am dying, that is where I would like to go.”

My brother in-law died there in 2014. My mother, we took care of her primarily through homecare hospice. So I have experience with hospice homecare and inpatient care as a clinician and as a family member. I got to see that training put into play for my own family: Treat everyone like you would your own family. 4. What are your thoughts on nonprofit vs. for-profit hospices?

When I started in hospice 32 years ago, 100 percent of all the agencies in Alabama were non-profits. If I recall correctly, there were 23 hospices in Alabama at the time.

I don’t remember when we started seeing the for-profits, but we started having competitors in the late 90s, and all of those were for-profits.

In 2020, Alabama had about 180 hospice offices and only 8 percent of those were non-profit.

Some people would say the only difference is tax status. I think there is more to it. If you are a for-profit, your purpose is to make money. If you are a not-for-profit, your purpose is to serve people, and how you make the decisions to lead your agency is from a different blueprint. For-profits and not-for-profits are different at the corporate level on how they administer their decisions.

For Shepherd’s Cove, we have tried to find multiple ways to serve – inpatient, homecare, bereavement, even our thrift shop.

All hospices, for-profit and non-profit, are under the same regulation. All are required to provide bereavement services. We have all of these actual bereavement programs, but what speaks loudly to me is that some for-profits simply have a directory of local grief services, and it is not uncommon that we are on that list.

We put our money into these programs – our profit. We do not necessarily have a big bank account to pay fees if we are out of compliance with regulations.

We had a homecare patient transfer to us from a for-profit because their response time would be several hours or sometimes the next day. Our policy is that we return a phone call within 15 minutes and make a visit within an hour, if it is needed.

Our corporate is local. Corporate decisions are made locally. For most forprofits, the corporate office is not even in Alabama. 5. What’s something most people don’t know about Rhonda Osborne?

A lot of people see me as being decisive and competent – a CEO. Over time my self-confidence grew, but a lot of times I faked it until I made it. I got out of my comfort zone and forced myself to put one foot in front of the other when I wasn’t so confident.

A lot of people also don’t know that when I moved back to Albertville, I loved rock climbing and rappelling. We’d go to Palisades Park in Blount County.

Now I love zip-lining. My first time was at Lake Guntersville State Park. Since then, I have taken my oldest grandsons on separate zip-lining trips to Gatlinburg. Ray doesn’t want any part of it!

You would think somebody hanging upside down, 150 feet up in the air, would be very confident. I don’t know about that, but it’s fun.