The US Department of Health and Human Services has initiated the decertification of Network for Hope, an organ procurement organisation serving Kentucky and parts of Indiana, Ohio and West Virginia. Federal officials cited continuing patient-safety failures, while the organisation strongly disputes the findings and plans to appeal.
Can the United States protect prospective organ donors while preserving access to lifesaving transplants?
The Department of Health and Human Services announced on August 5 that it had begun decertifying Network for Hope following multiple federal reviews of the organization’s safety practices.
Network for Hope is the federally designated organ procurement organization serving Kentucky and parts of Indiana, Ohio and West Virginia.
Organ procurement organizations, commonly known as OPOs, coordinate deceased-donor evaluation, consent, organ matching, recovery and transportation.
HHS said the action followed persistent deficiencies involving donor evaluation, adverse-event review, clinical oversight and organizational administration.
The official HHS announcement states that previous monitoring and opportunities for corrective action had not produced sufficient improvement.
“Americans who choose to become organ donors deserve a system that honors their gift and protects every patient,” Health Secretary Robert F. Kennedy Jr. said.
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Federal Review Examined 351 Uncompleted Donations
The Health Resources and Services Administration reviewed 351 Network for Hope cases between 2021 and 2024 in which organ donation had been authorised but was ultimately not completed.
Federal investigators reported that:
- 103 cases, or 29.3%, contained concerning features.
- 73 patients displayed neurological signs considered incompatible with organ donation.
- At least 28 patients may not have been deceased when organ-procurement activities began.
- Some neurological assessments were considered inadequate.
- Coordination between hospital medical teams and procurement personnel was insufficient in some cases.
- Investigators identified concerns involving consent and causes-of-death classifications, particularly in overdose cases.
These findings came from a 2025 HHS investigation. The cases involved authorized donations that were not completed and do not mean that organs were necessarily surgically removed from the patients concerned.
HHS subsequently required corrective action and monitoring. The department said later reviews by HRSA and the Centers for Medicare & Medicaid Services concluded that Network for Hope had not demonstrated sufficient improvement.
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Kentucky Patient’s Case Triggered Wider Scrutiny
The investigation followed widespread concern over the case of T.J. Hoover, a Kentucky man who was evaluated for organ donation after a drug overdose in 2021.
According to federal accounts and statements from his family, Hoover began showing signs of neurological activity while preparations for donation were underway. His sister said he opened his eyes, moved, cried and attempted to resist as the process continued.
Physicians ultimately refused to proceed with organ recovery, and the procedure was stopped. Hoover survived.
The case prompted federal investigators to examine other authorized but incomplete donations handled by the organization. It also led to congressional scrutiny and calls for stronger safeguards across the national organ-procurement system.
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Hospital Physicians Must Independently Declare Death
Organ procurement organizations do not have the authority to declare a patient dead. That responsibility belongs solely to the patient’s attending physician or another authorized hospital physician.(1✔ ✔Trusted Source
U.S. moves to decertify group that tried to collect organs from living patients
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The decision to withdraw life-sustaining treatment must also be made independently of the OPO and transplant-recovery team. An OPO may evaluate whether a patient is medically suitable for donation, but it cannot participate in the decision or timing of withdrawing life support or declaring death.
Organ donation may occur after:
- Death is determined using neurological criteria, commonly called brain death.
- Death is declared following the irreversible cessation of circulation and breathing.
The CMS guidance on organ-procurement responsibilities states that OPOs must confirm that death has been pronounced and obtain signed documentation before recovery begins.
If signs of life appear at any point, procurement activities must stop immediately. The patient’s neurological, cardiac and respiratory status should then be reassessed and documented.(1✔ ✔Trusted Source
U.S. moves to decertify group that tried to collect organs from living patients
Network for Hope Rejects the Federal Findings
Network for Hope said it “strongly disagrees” with the HHS decision and intends to appeal.
CEO Barry Massa said the organization complies with Organ Procurement and Transplantation Network policies and has implemented a formal procedure allowing staff to pause donation activities when safety, ethical or legal concerns arise.
The organization said this pause procedure helped inform safeguards adopted under Kentucky law. It also warned that decertification could disrupt services for more than 3,000 people awaiting transplants across its service area.
Network for Hope serves approximately seven million people across four states. Its concerns about potential disruption remain the organization’s position as the federal government prepares for continued oversight and possible replacement arrangements.
Decertification Is a Process, Not an Immediate Shutdown
Although HHS described its action as decertification, the department said it had begun the process. Network for Hope’s planned appeal means the administrative proceedings are not yet fully concluded.
CMS posted a formal termination notice for Network for Hope on August 5. Termination would remove the organization’s Medicare certification to operate as the federally designated OPO for its service area.
Federal officials said donation and transplant services would continue to be monitored during the process. HRSA and CMS are expected to oversee continuity of care and prepare for another organization to assume responsibility if the decertification becomes final.
If completed, the action would make Network for Hope the second OPO to lose federal certification following the earlier termination of the Miami-based Life Alliance Organ Recovery Agency.
Organ Donation Remains a Lifesaving Medical Practice
More than 100,000 people in the United States are waiting for an organ transplant, according to the Organ Procurement and Transplantation Network. Kidneys account for most of the demand.
The medical team treating a patient and attempting to save their life is separate from the surgical team responsible for recovering organs after death. Organ donation proceeds only after death has been legally determined and authorization has been verified.
A transplant surgical team replaces the treating medical team only after the required medical, legal and consent procedures have been completed. This separation is intended to protect patients and prevent organ-donation considerations from influencing treatment decisions.
Stronger Safeguards Aim to Restore Public Trust
Concerns about donor safety could weaken public confidence and reduce organ registrations.
HHS is strengthening oversight through patient-safety officers, independent death verification, clearer separation of medical and procurement teams, non-coercive consent, immediate reassessment when signs of life appear and transparent reporting.
These safeguards are essential to protect donors, respect families and preserve trust in lifesaving transplantation.
References:
- U.S. moves to decertify group that tried to collect organs from living patients- (https://www.washingtonpost.com/health/2026/08/05/us-decertifies-transplant-group-that-tried-collect-organs-living-patients/)
Source-Medindia