The federal government has decertified Network for Hope (NFH), a Kentucky-based organ procurement organization, after an investigation found significant failures, including allegations of attempting to procure organs from individuals who showed signs of being alive. Health and Human Services Secretary Robert F. Kennedy Jr. announced the action Wednesday, labeling the organization a "bad apple" that necessitated government intervention after repeated warnings.
An investigation by the Health Resources and Services Administration (HRSA) reviewed 351 cases where organ donation was authorized but not completed. The review found "serious deficiencies" in nearly 30 percent of these cases. Specifically, 73 patients, over 20 percent, displayed neurological signs indicating they were still alive when the organization initiated organ procurement. The report also indicated that at least 28 patients may not have been deceased at the time procurement was started.
Officials cited poor neurologic assessments, questionable consent practices, and misclassification of causes of death as findings. In many cases involving overdose patients, individuals exhibited depressed mental status from drug effects rather than terminal illness, complicating assessments.
The decision followed a federal investigation into the case of Anthony Thomas “TJ” Hoover II, a 36-year-old Kentucky man who reportedly woke up in 2021 as doctors prepared to remove his organs. Hoover had been rushed to Baptist Health Hospital in Richmond following a drug overdose. Though doctors declared him brain dead and his family authorized organ donation, witnesses, including former employees, reported that Hoover began thrashing and making eye contact on the operating table. A hospital doctor ultimately refused to proceed with life support removal, and Hoover survived, although he has been left with significant neurological injuries. His sister has been his caregiver for several years.
Network for Hope, formerly known as Kentucky Organ Donor Affiliates (KODA), serves seven million people across Kentucky and parts of Indiana, Ohio, and West Virginia. The organization has stated it strongly disagrees with the decision and plans to appeal. A spokesperson for NFH noted that the organization is compliant with all policies and has implemented a "pause in procedure" process.
This decertification is part of a broader reform initiative announced by Secretary Kennedy in July 2025, which aims to enhance safeguards in organ allocation, strengthen misconduct reporting systems, and require patient safety officers at all organ procurement groups. Previously, the approximately 55 federally contracted organ procurement organizations had not faced closure.