Document:

VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.62

AMENDMENT NO. 4

TO

AMENDED AND RESTATED EMPLOYMENT AGREEMENT

            This Amendment No. 4 (this “Amendment’) dated as of May 5, 2009, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Keith B.
Pitts (the “Executive”).

            WHEREAS, the Company and the Executive executed a certain Amended and Restated Employment  Agreement,  dated as of September 23, 2004, as further amended (collectively, the
“EA”), to secure the services of the Executive as Vice Chairman; and

            WHEREAS, the Company and the Executive wish the Executive’s base salary set forth in Section 6(a) of the EA to be increased to $685,000, effective as of April 1, 2009.

            NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and the Executive hereby agree that the EA is amended as follows:

            1.         Defined Terms.  Except for those terms defined above, the definitions of capitalized terms used in this Amendment are as provided in
the EA.

            2.         Amendment to Section 6(a).  Section 6(a) of the EA entitled “Base Salary” is hereby  deleted and replaced with
the following new Section 6(a):

                        “(a)  Base Salary.  Effective April 1, 2009, the Executive’s base salary hereunder

                        shall be $685,000 per year, payable semi-monthly. Commencing July 1, 2010,the

                        Board shall review such base salary at least annually and make such adjustments from

                        time to time as it may deem advisable, but the base salary shall not at any time be

                        reduced from the base salary in effect from time to time.”

            3.         Ratification.  All other provisions of the EA remain unchanged and are hereby  ratified  by the Company and the
Executive.

1

            IN WITNESS WHEREOF, the Company has caused this Amendment to be executed by its duly authorized officer and the Executive has executed this Amendment, each as of the day and year first set
forth above.

                                                                       
Vanguard Health Systems, Inc.

                                                                       
By:/s/ Ronald P. Soltman                                 

                                                                                   
Ronald P. Soltman

                                                                                   
Executive Vice President

                                                                       
Executive:

                                                           
            /s/ Keith B/
Pitts                                              

                                                                       
Keith B. Pitts

2VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.63

AMENDMENT NO. 4

TO

AMENDED AND RESTATED EMPLOYMENT AGREEMENT

            This Amendment No. 4 (this “Amendment’) dated as of May 5, 2009, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Ronald P.
Soltman (the “Executive”).

            WHEREAS, the Company and the Executive executed a certain Amended and Restated Employment  Agreement  dated as of September 23, 2004, as further amended  (collectively, the
“EA”),  to secure the services of the Executive as Executive Vice President, General Counsel and Secretary; and

            WHEREAS, the Company and the Executive wish the Executive’s base salary set forth in Section 6(a) of the EA to be increased to $549,040, effective as of April 1, 2009.

            NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and the Executive hereby agree that the EA is amended as follows:

            1.         Defined Terms.  Except for those terms defined above, the definitions of capitalized terms used in this Amendment are as provided in
the EA.

            2.         Amendment to Section 6(a).  Section 6(a) of the EA entitled “Base Salary” is hereby  deleted and replaced with
the following new Section 6(a):

                        “(a) Base Salary.  Effective April 1, 2009, the Executive’s base salary hereunder shall

                        be $549,040 per year, payable semi-monthly. Commencing July 1, 2010, the Board

                        shall review such base salary at least annually and make such adjustments from time

                        to time as it may deem advisable, but the base salary shall not at any time be reduced

                        from the base salary in effect from time to time.”

            3.         Ratification.  All other provisions of the EA remain unchanged and are hereby  ratified by the Company and the Executive.

1

            IN WITNESS WHEREOF, the Company has caused this Amendment to be executed by  ts duly authorized officer and the Executive has executed this Amendment, each as of the day and year first
set forth above.

                                                                       
Vanguard Health Systems, Inc.

                                                                       
By:/s/ Phillip W.
Roe                                        

                                                                                   
Phillip W. Roe

                                                                                   
Executive Vice President, Chief Financial

                                                                                   
Officer and Treasurer

                                                                       
Executive:

                                                                       
/s/ Ronald P. Soltman                                      

                                                                       
Ronald P. Soltman

2VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.64

AMENDMENT NO. 1

TO

EMPLOYMENT AGREEMENT

            This Amendment No. 1 (this “Amendment’) dated as of May 5, 2009, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Kent H.
Wallace (the “Executive”).

            WHEREAS, the Company and the Executive executed a certain Employment Agreement  dated as of November 15, 2007 ( the “EA”),  to secure the services of President and
Chief Operating Officer; and

            WHEREAS, the Company and the Executive wish the Executive’s base salary set forth in Section 6(a) of the EA to be increased to $685,000, effective as of April 1, 2009.

            NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and the Executive hereby agree that the EA is amended as follows:

            1.         Defined Terms.  Except for those terms defined above, the definitions of capitalized terms used in this Amendment are as provided in
the EA.

            2.         Amendment to Section 6(a).  Section 6(a) of the EA entitled “Base Salary” is hereby  deleted and replaced with
the following new Section 6(a):

                        “(a)  Base Salary.  Effective April 1, 2009, the Executive’s base salary hereunder

                        shall be $685,000 per year, payable semi-monthly. Commencing July 1, 2010, the

                        Board shall review such base salary at least annually and make such adjustments from

                        time to time as it may deem advisable, but the base salary shall not at any time be

                        reduced from the base salary in effect from time to time.”

            3.         Ratification.  All other provisions of the EA remain unchanged and are hereby  ratified  by the Company and the
Executive.

1

                        IN WITNESS WHEREOF, the Company has caused this Amendment to be executed by  its duly authorized officer and the
Executive has executed this Amendment, each as of the day and year first set forth above.

                                                                       
Vanguard Health Systems, Inc.

                                                                       
By:/s/ Ronald P. Soltman                                 

                                                                                   
Ronald P. Soltman

                                                                                   
Executive Vice President

                                                                       
Executive:

                                                                       
/s/ Kent H.
Wallace                                         

                                                                       
Kent H. Wallace

2VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.65

AMENDMENT NO. 1

TO

EMPLOYMENT AGREEMENT

            This Amendment No. 1 (this “Amendment’) dated as of May 5, 2009, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Phillip W.
Roe (the “Executive”).

            WHEREAS, the Company and the Executive executed a certain Employment Agreement  dated as of November 15, 2007 ( the “EA”),  to secure the services of the Executive as
Executive Vice President, Chief Financial Officer and Treasurer; and

            WHEREAS, the Company and the Executive wish the Executive’s base salary set forth in Section 6(a) of the EA to be increased to $525,000, effective as of April 1, 2009.

            NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and the Executive hereby agree that the EA is amended as follows:

            1.         Defined Terms.  Except for those terms defined above, the definitions of capitalized terms used in this Amendment are as provided in
the EA.

            2.         Amendment to Section 6(a).  Section 6(a) of the EA entitled “Base Salary” is hereby  deleted and replaced with
the following new Section 6(a):

                        “(a)  Base Salary.  Effective April 1, 2009, the Executive’s base salary hereunder

                        shall be $525,000 per year, payable semi-monthly. Commencing July 1, 2010, the

                        Board shall review such base salary at least annually and make such adjustments from

                        time to time as it may deem advisable, but the base salary shall not at any time be

                        reduced from the base salary in effect from time to time.”

            3.         Ratification.  All other provisions of the EA remain unchanged and are hereby  ratified by the Company and the Executive.

1

            IN WITNESS WHEREOF, the Company has caused this Amendment to be executed by its duly authorized officer and the Executive has executed this Amendment, each as of the day and year first set
forth above.

                                                                       
Vanguard Health Systems, Inc.

                                                                       
By:/s/ Ronald P. Soltman                                 

                                                                                   
Ronald P. Soltman

                                                                                   
Executive Vice President

                                                                       
Executive:

                                                                       
/s/ Phillip W.
Roe                                             

                                    
                                    Phillip W. Roe

2

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