X0306 4 2013-05-24 0001045829 VANGUARD HEALTH SYSTEMS INC VHS 0001551612 CHARLES N. MARTIN, JR. 2012 IRREVOCABLE GRANTOR RETAINED ANNUITY TRUST u/a/d May 24, 2012 20 BURTON HILLS BOULEVARD SUITE 100 NASHVILLE TN 37215 0 0 0 1 Member of 10% owner group Common Stock 2013-05-24 5 G 0 46541 0 D 108351 D The grantor retained annuity trust made an annuity distribution of 46,541 shares of common stock to the Charles N. Martin, Jr. 2013 Irrevocable Grantor Retained Annuity Trust at the direction of Mr. Martin. /s/ James H. Spalding, Attorney-in-Fact 2013-05-29