Axiom Gardens of Nashville: CNA Training Failures - IL
The surveyor had asked to see the facility's in-service education records for its nursing assistants. What came back documented a training program that had, by any honest measure, collapsed. One aide, identified in inspection records as V32, had one hour of documented education for the year. Another, V34, also had one hour. Three others, V33, V35, and V37, had two hours, two hours, and two and a half hours respectively. V36, a certified nursing assistant who had been working at the facility since March of 2019, had no documented education at all for the past year.
The requirement is 12 hours annually.
The administrator, identified in the inspection report as V1, did not dispute any of it. "I have to be honest," she told the surveyor at 12:29 in the afternoon. "That is all we have for the CNA in-services/education for the past year." She confirmed the aides were supposed to receive 10 to 12 hours of continuing education per year. She explained that the in-services that had been provided to the surveyor were all 30-minute sessions, with the exception of one wound care training that ran a full hour. That was the whole of it.
Later that afternoon, at 1:43 PM, the surveyor went back through the numbers with both the administrator and the Director of Nursing, identified as V2. Both agreed. V32, V33, V34, V35, V36, and V37 had not received the required 12 hours of education in the past year.
The six aides whose records were reviewed had been working in long-term care for years, in some cases decades. V35 had a hire date of November 4, 1999. V33 had been working since January of 2002. V32 had been at the facility since July of 2011. These were not new employees still learning the job. They were experienced aides, some with more than 20 years in the field, and the facility had provided them with training that amounted to a few half-hour sessions spread across an entire year.
The facility's own Employee Education policy, dated October 1, 2022, laid out what annual training was supposed to cover: infection prevention, fire safety and emergency procedures, abuse and neglect, accident prevention, residents' rights, bloodborne pathogen exposure, federal and state regulatory requirements, and quality assurance. The policy also required that all employees receive dementia training within 60 days of hire and annually after that.
On the question of dementia training, the administrator's answer at 2:17 PM was its own kind of admission. She told the surveyor she thought the facility had done dementia training back in February of 2025. She could not find the attendance records for it. When the surveyor asked whether the facility was providing dementia training to new employees within 60 days of hire, as its own policy required, the administrator did not claim the records were misplaced. She said: "We are not doing that."
A new company had taken over operations at the facility on November 1, 2025, roughly a month before the inspection. The administrator noted that the CNA hire list reflected both the aides' original hire dates and the date of the ownership transition. The inspection was conducted on December 2nd and December 24th, 2025, as a complaint inspection.
The training gap documented here is not a paperwork problem. The annual in-service requirement for nursing home aides exists because the work involves direct, daily contact with some of the most vulnerable people in any community, residents who depend on aides to help them eat, bathe, move, and communicate. Training on abuse prevention, dementia care, and infection control is not background material. It is the foundation of safe care. An aide who has not been trained on how to recognize or report abuse is less equipped to protect a resident from it. An aide who has received no dementia training is less equipped to respond to a resident whose behavior, communication, and needs are shaped by cognitive decline.
The facility's census on December 2nd was 60 residents.
Inspectors rated the violation at the level of minimal harm or potential for actual harm, the lower end of the severity scale. The potential, they noted, extended to all 60 residents in the building.
What the records do not show is how the training gap developed. The new ownership took over November 1st, and the inspection came 31 days later. But the aides whose records were reviewed had been employed long before the ownership change, some of them for years and years under whatever management preceded the current one. V35, hired in 1999, and V33, hired in 2002, had been working in this building through multiple ownership arrangements, multiple directors of nursing, multiple administrators. The one-hour and two-hour totals in their 2025 training records are the end result of decisions made, or not made, throughout that time.
The administrator who sat across from the surveyor on December 2nd inherited a training program that was already bare. She acknowledged it plainly. She could not produce records for the dementia training she believed had happened in February. She confirmed the facility was not providing new-hire dementia training as its own policy required. She offered no competing explanation for the numbers.
What she said, in effect, was: this is what we have.
For the aides themselves, the inspection record draws no conclusions about the quality of care they provided. Their names do not appear. Their residents' names do not appear. The inspection was focused on documentation, on what training had been completed and recorded, and on the gap between what the records showed and what the requirement demanded.
But the residents are there. Sixty of them, on any given day, in rooms along the hallways of Axiom Gardens of Nashville, cared for by aides who spent the better part of 2025 without structured training on how to prevent abuse, how to respond to dementia, how to handle the daily emergencies that arise in a building full of people who cannot always ask for what they need.
The facility's policy said the staff education plan would be reviewed annually by a quality assurance committee and revised as needed. If that review happened in 2025, it did not produce the training hours the aides needed. If it did not happen, nobody caught the gap until a surveyor arrived in December and asked to see the records.
Either way, the administrator's answer was the same. That is all we have.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Axiom Gardens of Nashville from 2025-12-24 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 19, 2026 · Our methodology
Axiom Gardens of Nashville in NASHVILLE, IL was cited for violations during a health inspection on December 24, 2025.
The surveyor had asked to see the facility's in-service education records for its nursing assistants.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.