X0306 4 2012-09-20 0001045829 VANGUARD HEALTH SYSTEMS INC VHS 0000905201 MARTIN CHARLES N JR 20 BURTON HILLS BOULEVARD SUITE 100 NASHVILLE TN 37215 1 1 0 1 Chairman & CEO Member of 10% owner group Common Stock 2012-09-20 4 A 0 69433 0 A 3569823 D Common Stock 2012-09-20 4 F 0 6379 11.81 D 3563444 D Common Stock 154892 I By Charles N. Martin, Jr., 2012 Irrevocable Grantor Retained Annuity Trust Common Stock 62471 I By Charles N. Martin, Jr., 2011 Irrevocable Grantor Retained Annuity Trust Common Stock 79091 I By Martin Children's Irrevocable Trust Employee Stock Option (Right to Buy) 11.81 2012-09-20 4 A 0 141701 0 A 2022-09-20 Common Stock 141701 141701 D Represents common stock underlying 69,433 restricted stock units which shall vest in four equal installments on the first, second, third and fourth anniversaries of the 09/20/2012 grant date (or earlier upon a change of control). The stock options vest and become exercisable with respect to thirty-three and one-third percent (33 1/3%) of the underlying shares on each of the first, second and third anniversaries of the 09/20/2012 grant date (or earlier upon a change of control). /s/ James H. Spalding, Attorney-in-Fact 2012-09-24