The Trump administration is pulling the federal certification of an organ procurement organization that serves nearly 7 million people across four states, after investigators found that dozens of patients flagged for organ donation were still showing neurological signs of life.
HHS Secretary Robert F. Kennedy Jr. announced Wednesday that the Department of Health and Human Services has begun decertification proceedings against Network for Hope, a federally designated organ procurement organization headquartered in Cincinnati and Louisville. The group handles organ donation across Kentucky and parts of Indiana, Ohio, and West Virginia. Kennedy said the action follows multiple federal reviews that documented persistent patient-safety failures, failures he said the Biden administration chose not to address.
The case at the center of the announcement is difficult to read. A man identified as T.J. Hoover was hospitalized after an overdose in 2021 and was slated for organ donation. Kennedy said at the announcement that Hoover showed signs of awareness while on the operating table as his organs were about to be removed. Physicians refused to proceed because they believed he was still alive.
Kennedy brought Hoover to the announcement as a living example of what went wrong. His sister, Donna Rohrer, did not hold back.
Rohrer told the Washington Examiner:
"My brother almost died that day. That should never happen to anyone. Laws and standards were clearly violated. Those responsible must be held accountable."
The numbers behind the decertification are stark. The Health Resources and Services Administration, an HHS sub-agency, examined 351 cases between 2021 and 2024 in which organ donation was authorized but never completed. Of those, 103, roughly 29.3 percent, showed what investigators called "concerning features." Seventy-three of those patients displayed neurological signs incompatible with organ donation, meaning they showed brain activity or reflexes that should have stopped the process cold.
Federal investigators also found evidence of inadequate neurological assessments, poor consent practices, and pressure on medical personnel to proceed with organ recovery despite patients showing active signs of life. Fox News senior medical analyst Dr. Marc Siegel put the findings bluntly:
"Thirty percent of the procedures that they were performing had something wrong with them."
Siegel added that Kennedy "is bringing to light horror stories about the dark corners of organ harvesting."
The administration's broader push for accountability in health care has produced friction inside its own ranks. FDA Commissioner Marty Makary recently stepped down after clashing with the White House on vape approvals, a reminder that the administration's willingness to act on health policy does not stop at external targets.
Kennedy framed the decertification as a direct correction of his predecessor's inaction. Just the News reported Kennedy's full statement:
"Under the Biden administration, HHS failed to hold organizations accountable when serious patient concerns emerged. Today we are restoring that accountability. We will not tolerate organizations that compromise patient safety or betray the trust of donors or their families."
That framing carries weight because the problems documented in the HRSA review span from 2021 to 2024, the entirety of the Biden term. The question Kennedy is raising is not just whether Network for Hope failed. It is whether the federal government saw the failures and looked the other way.
Network for Hope plans to appeal the decertification. Tiffany Mattingly, the organization's chief engagement officer and vice president of Clinical Strategies, told NPR that local hospitals remain "hopeful that any issues identified by HHS can be resolved promptly, so that the Network for Hope can return to its full focus to their critical life-saving mission."
But area hospitals themselves appear less alarmed than Network for Hope's leadership. NPR reported that hospitals in the service area do not anticipate a significant impact on patient care, a signal that the decertification may not produce the disruption the organization warns about.
Network for Hope has pushed back by pointing to the more than 3,000 people on transplant waiting lists in its service area. The organization argues the decertification will harm those patients. That claim deserves scrutiny. More than 100,000 Americans sit on the national transplant waiting list. Roughly 13 people die each day waiting for an organ. The stakes in organ procurement are real and measured in lives.
But the stakes cut both ways. A system that pressures staff to harvest organs from patients who may still be alive does not protect donors or the public trust that makes organ donation possible. The country performed a record 49,064 organ transplants in 2025, drawing from 23,788 donors. More than 170 million Americans are registered as organ, eye, and tissue donors. That system depends entirely on the belief that no one will be declared dead prematurely to fill a quota.
The Trump administration has made life-related policy a consistent priority, from amended abortion policies to the Right to Try Act. This latest action fits that pattern, and extends it into territory that crosses partisan lines. The idea that a federally certified organization might have initiated organ procurement on patients still showing signs of life is not a left-right issue. It is a basic question of whether the government is doing its job.
President Trump has also demonstrated a willingness to act directly on individual cases that align with his administration's values. He personally raised the case of Pastor Ezra Jin Mingri with Chinese President Xi Jinping, securing the pastor's release, the kind of direct intervention that defines the administration's approach to accountability at every level.
Network for Hope is not the first organ procurement organization to lose its federal certification under Kennedy's watch. The New York Post reported that HHS decertified the University of Miami Health System's organ procurement operation in September 2025. That earlier action, combined with congressional investigations and whistleblower testimony, suggests the problems at Network for Hope are not isolated. They point to systemic failures across the organ procurement industry that went unaddressed for years.
The Washington Examiner described the decertification as following a yearlong federal investigation, an indication that the Trump administration did not act hastily but built its case over an extended review period before moving against the organization.
Several open questions remain. The precise timeline and grounds of Network for Hope's appeal have not been disclosed. It is unclear what happens operationally during the decertification process, whether Network for Hope's activities halt immediately or continue during a transition period. And the full scope of what investigators found beyond the HRSA case review has not been made public.
The administration continues to press on multiple fronts simultaneously. Speaker Johnson recently promised to send a housing bill to Trump's desk, and Treasury Secretary Bessent signaled a potential Hormuz deal with Iran could close imminently. The organ procurement action may not generate the same headlines, but for the families of patients caught in a broken system, it may matter more than any of them.
When the government certifies an organization to decide who is dead and who is not, it had better make sure that organization gets the answer right. For at least 73 patients in Kentucky and its neighboring states, it did not. That someone finally acted on it is not remarkable. That it took this long is.
