HHS Secretary Robert F. Kennedy Jr. decertified a Kentucky-based organ procurement nonprofit after federal reviewers found serious deficiencies in nearly a third of cases examined, including patients who were still alive when staff tried to harvest their organs.
Kennedy announced the decision Wednesday in Lexington, Kentucky, making Network for Hope the first of roughly 55 federally contracted organ procurement organizations ever shut down by the government. The Health Resources and Services Administration reviewed 351 cases where organ donation had been authorized but never completed at the nonprofit, and what investigators found was grim: 103 of those cases, 29.3 percent, showed what the agency called "concerning features."
Seventy-three patients in the review displayed neurological signs indicating they were still alive when the organization moved to harvest their organs. At least 28 may not have been deceased at all when procurement began. The investigation also uncovered poor neurological assessments, questionable consent practices, and misclassified causes of death, particularly in overdose cases where patients were temporarily showing depressed brain activity from drug effects rather than terminal illness.
Network for Hope, formerly known as Kentucky Organ Donor Affiliates, coordinates organ donations across Kentucky and parts of Indiana, Ohio, and West Virginia. It serves roughly seven million people across four states. Until Wednesday, no organ procurement group had ever lost its federal certification.
Kennedy did not hold back. As the Daily Mail reported, the HHS secretary laid out the findings plainly:
"We found patients placed on the organ donation pathway who should have never been there. We found repeated failures in clinical judgment, oversight and patient safety."
The case that brought NFH under national scrutiny, and eventually before Congress, involved a 36-year-old Kentucky man named Anthony Thomas "TJ" Hoover II. His story is not an abstraction. It is the kind of account that forces a reader to reckon with what happens when institutional oversight fails and no one with authority says stop.
In 2021, Hoover was rushed to Baptist Health Hospital in Richmond, Kentucky, after a drug overdose. Doctors declared him brain dead. His family, trusting the medical professionals in front of them, authorized organ donation.
But Hoover was not dead.
Former NFH employee Nyckoletta Martin told investigators that Hoover had actually woken up hours earlier during a cardiac catheterization procedure. Staff sedated him and continued the case. Then, when Hoover was taken to the operating room for organ procurement, he woke up again, thrashing on the table, making eye contact with the people in the room, and crying.
Natasha Miller, a former organ preservationist who was present in the operating room that day, described the scene in prior comments to the Daily Mail:
"I was just trying to focus on my job, and then once I actually saw him for myself, crying, that was kind of, it makes you feel like, what are we doing?"
A hospital doctor ultimately refused to remove Hoover from life support. That refusal likely saved his life. But Miller alleged that higher-ups at the organization pressured staff to proceed with the organ removal. She said one supervisor told a coordinator to "find another doctor to do it" or face termination.
Miller did not stop at the Hoover case when describing the organization's culture.
"It's not always ethical, and that's what needs to change."
Hoover's sister, Donna Rhorer, was told to take him home and make him comfortable. She was told he would not live long. Years later, she is still caring for him. Hoover lives with neurological injuries that affect his balance, speech, vision, and short-term memory.
Rhorer shared that Hoover had gotten into narcotics after dealing with PTSD, anxiety, and depression. He overdosed, was declared dead, was wheeled into an operating room to have his organs removed, and woke up crying on the table. The system that was supposed to help him nearly killed him, and the organization at the center of it kept operating for years afterward.
Rep. Neal Dunn, a Florida Republican on the House Committee on Energy and Commerce, participated in congressional hearings on the Hoover case. He called it "a story more fitting for a horror movie than a congressional hearing."
Network for Hope did not go quietly. CEO Barry Massa issued a statement strongly disagreeing with Kennedy's decision, insisting the organization had done nothing wrong.
"NFH is compliant with all OPTN policies and has implemented a first-of-its-kind 'pause in procedure' process."
Massa went further, framing the decertification as an overreach that would hurt the patients the system is supposed to serve:
"Despite this, and despite NFH's demonstrated dedication to improving organ and tissue donation outcomes across its service area, Secretary Kennedy has acted to decertify our OPO that serves seven million people across four states."
The organization said it plans to appeal. But Massa's statement did not address the 73 patients who showed neurological signs of life during procurement attempts, the 28 who may not have been deceased when the process started, or the specific allegations from former employees about pressure to continue procedures on a patient who was visibly alive and responsive.
Claiming compliance with industry policies is one thing. Explaining why nearly a third of reviewed cases raised red flags with federal investigators is another.
The NFH decertification did not happen in a vacuum. Kennedy announced a broader reform initiative in July 2025 aimed at the organ procurement system nationwide. The reforms include safeguards designed to prevent line-skipping in organ allocation, a strengthened misconduct reporting system, and a new requirement that all organ procurement groups hire patient safety officers.
Before this action, the roughly 55 organizations that hold federal contracts to manage organ donations had never faced closure. The system operated for decades with no group losing its certification, a track record that could reflect either universal excellence or a near-total absence of accountability. The HRSA investigation into Network for Hope suggests the latter.
Several questions remain unanswered. No criminal charges have been publicly reported in connection with the Hoover case or the broader investigation findings. It is unclear what entity will take over organ procurement services for the seven million people in NFH's four-state service area, or how quickly a transition can happen. The timeline and mechanics of NFH's planned appeal are also unknown.
And the 73 patients who showed signs of life, and the 28 who may not have been dead, are numbers in a federal report. Each one was a person on a table, in a room, surrounded by professionals whose job was to make the right call. The investigation found that in case after case, they did not.
When a system goes decades without holding anyone accountable, it should not come as a surprise that someone eventually has to step in and do it from the outside. The only real question is why it took this long.
