HHS moves to shut down Kentucky organ procurement group, citing years of patient safety failures
The U.S. Department of Health and Human Services said Wednesday that it is moving to terminate Network for Hope, the Louisville-based organization that coordinates organ donations across Kentucky and parts of three neighboring states, after federal investigators documented years of what they called serious patient safety problems.
Health and Human Services Secretary Robert F. Kennedy Jr. announced the action at a news conference in Lexington, describing Network for Hope as a “bad apple” and saying the government had a duty to intervene after the group repeatedly put patients at risk.
“When an organization entrusted with the gift of life repeatedly puts patients at risk, the federal government has the duty to act, and that's why we're acting today,” Kennedy said.
Network for Hope immediately pushed back, saying it “strongly disagrees” with the decision and plans to appeal. The nonprofit was formed in 2024 through the merger of Kentucky Organ Donor Affiliates and LifeCenter Organ Donor Network, and it serves roughly 7 million people across Kentucky and counties in southern Indiana, Ohio and West Virginia. It is the country's 16th-largest organ procurement organization, with more than 300 employees.
The federal action caps more than a year of scrutiny that resurfaced after a whistleblower told Congress about a harrowing case involving TJ Hoover, a Kentucky man who said he woke up on an operating table in 2021 as staff were preparing to harvest his organs. Hoover had overdosed and arrived at the hospital in cardiac arrest. After several days without responding, he suddenly became conscious while his chest was being shaved and his body was bathed in surgical solution, and he heard staff discussing how they would take his organs, according to his sister.
Hospital staff had raised concerns that Hoover seemed aware and was resisting, but the organ procurement organization at the time kept “pushing, pushing, pushing to go,” Natasha Miller, a perfusionist who worked with the group, told CNN. A doctor eventually called off the procedure. Hoover survived and now lives with his sister, Donna Rhorer, in Richmond, Kentucky, where he continues extensive physical therapy and treatment.
At the time, Network for Hope said it had reviewed Hoover's case and remained “confident that accepted practices and approved protocols were followed.” It also said the case had been “inaccurately represented,” including by people who were not involved.
Hoover and Rhorer attended Wednesday's announcement. Kennedy thanked Hoover and praised the physicians who stopped the surgery, saying Hoover's story was a reminder that “every safeguard exists for a reason.” He added that while most organ procurement organizations operate with compassion and respect, Network for Hope “repeatedly failed to meet those standards.”
Federal investigators from the Health Resources and Services Administration reviewed 351 cases involving Network for Hope's predecessor in which organ donation was authorized but not completed. More than 100 cases had “concerning features,” including 73 patients with neurological signs that were incompatible with organ donation, according to HHS. Investigators also cited poor neurological assessments, inconsistent coordination with hospital medical teams, questionable consent practices and misclassification of causes of death.
“Despite intensive oversight, ongoing monitoring by the OPTN and repeated opportunities for improvement, significant patient safety concerns remained,” HRSA Administrator Thomas Engels said Wednesday. He stressed that patients served by Network for Hope will continue to receive care while the agency moves forward.
Network for Hope CEO Barry Massa said the organization is “compliant with all OPTN policies” and argued that under HRSA oversight, organ donation in its region declined for the first time in 14 years. He said more than 3,000 people waiting for transplants could be harmed by the decision.
The move is part of a broader federal crackdown on organ procurement organizations, the 55 nonprofit groups that manage the logistics of the U.S. transplant system. These groups send staff into hospitals to assess whether organs can be used, match donors with recipients, counsel grieving families and arrange the transfer of organs. Because the system depends on volunteer donors, many of whom sign up while getting a driver's license, experts say public trust in these organizations is critical.
About 170 million people in the U.S. have registered as organ donors, but less than 1% ultimately meet the strict medical criteria for donation. Last year, more than 48,000 transplants were performed, while more than 103,000 people remained on waiting lists. Another person is added to the list every eight minutes, and about 17 people die each day waiting for a transplant, according to HRSA.
Federal oversight reports have repeatedly identified problems across the OPO system, yet meaningful corrective action has been slow. In January, the Government Accountability Office said investigations into the donation system have produced little in the way of fixes. Separately, a federal investigation found that mismanagement can lead to donated organs being discarded, mishandled or lost, and the Centers for Medicare & Medicaid Services has estimated that about 28,000 donated organs go unused because of inefficiencies.
In September, HHS moved to shut down Life Alliance Group, another OPO affiliated with the University of Miami, after finding chronic understaffing, safety concerns and underperformance that officials said cost opportunities to recover organs from viable donors. Around the same time, Kennedy directed every OPO to have an Organ Procurement and Transplantation Network patient safety officer in place to investigate problems in real time.
Kentucky has also stepped up oversight. A state law that took effect in July allows any staff member involved in the transplant process to stop a procedure if they have concerns, requires proper documentation of donor consent, and makes clear that a patient must be formally declared dead before organs can be removed.
Rhorer said Wednesday that when her brother was sent home from the hospital, she was told to make him comfortable because he would not live long. That was five years ago.
“We're barely scraping by. My life is taking care of my brother, and it wears me out sometimes. But this isn't just about TJ. Families deserve confidence that every patient is treated safely and every safeguard is followed,” she said. “If we don't act, this will happen again. I will keep fighting until the people responsible are held accountable so no other family has to live what we're living here.”