In some instances, potential donors may not have been deceased when organ procurement procedures were initiated.
The US Department of Health and Human Services (HHS) has decertified an organ procurement organization (OPO) after multiple federal reviews found significant patient safety concerns.
Network for Hope, a federally designated OPO that serves Kentucky and parts of Indiana, Ohio, and West Virginia, was decertified based on findings by the Centers for Medicare & Medicaid Services (CMS). According to HHS, federal reviews found “persistent patient safety failures despite extensive oversight and despite Network for Hope having been provided repeated opportunities to correct them.”
HHS also said the failures placed prospective organ donors and patients awaiting life-saving transplants at risk.
The action follows concerns identified last year by HHS’ Health Resources and Services Administration (HRSA), which directed the Organ Procurement and Transplantation Network (OPTN) to implement a monitoring plan for Network for Hope. The increased oversight followed reports alleging that staff was pressuring doctors to move forward with removing organs even after some previously unresponsive patients had begun showing signs of regaining consciousness.
HRSA and CMS subsequently conducted independent reviews. HRSA evaluated whether Network for Hope had successfully implemented corrective actions, while CMS assessed whether the organization continued to meet the federal requirements necessary to remain certified to participate in Medicare.
HRSA identified 351 cases between 2021 and 2024 where organ donation was authorized but ultimately not completed by Network for Hope. In 103 cases, representing 29 percent, there were concerning features, including 73 patients who had neurological signs incompatible with organ donation. It also found that in some instances, potential donors may not have been deceased when organ procurement procedures were initiated. HHS said that evidence suggested there were “poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly in overdose cases.”
“HRSA, through its oversight of the OPTN, worked closely with Network of Hope over the past year through intensive monitoring and corrective action to address serious patient safety concerns,” said HRSA Administrator Tom Engels. “Despite those efforts, the organization did not demonstrate the improvements necessary to meet federal standards. When organizations entrusted with the care of potential organ donors fail to meet those standards, we have a responsibility to act. Our priority is protecting patients, honoring the generosity of donor families, and ensuring every donated organ has the greatest possible opportunity to save a life.”
CMS’s decertification of Network for Hope is part of broader reforms announced by HHS Secretary Robert F. Kennedy Jr in July of 2025 aimed at overhauling the nation’s organ procurement system.
“Americans who choose to become organ donors deserve a system that honors their gift and protects every patient,” said Kennedy. “Today’s action reflects the Trump Administration’s commitment to protecting the sanctity of life. Organizations that repeatedly fail to meet federal standards and put patients at risk will be held accountable.”
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