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                                                                   EXHIBIT 10.15

                              AMENDED AND RESTATED
                              EMPLOYMENT AGREEMENT

      THIS AMENDED AND RESTATED EMPLOYMENT AGREEMENT (this "Agreement") dated as
of September 23, 2004, 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 an employment agreement
dated as of September 1, 1999 (the "Original Employment Agreement"), which was
first amended as of May 31, 2001, and was subsequently amended as of January 1,
2004 (with such amendments, the "Existing Employment Agreement");

      WHEREAS, the Company has entered into an agreement and plan of merger by
and among VHS Holdings LLC, Health Systems Acquisition Corp. and the Company,
dated as of July 23, 2004 (the "Merger Agreement") whereby the Health Systems
Corp. will merge into the Company with the Company as the surviving corporation;

      WHEREAS, the Executive currently serves as Vice Chairman of the Company;

      WHEREAS, the Company desires to secure for itself or its subsidiary the
continuing services of the Executive from and after the date hereof and the
Executive desires to render such services, in each case pursuant to the terms
and conditions hereof;

      WHEREAS, the Company's Board of Directors (the "Board"; provided, that if
a Compensation Committee of the Board of Directors shall have been duly
appointed, the term "Board" as used herein shall mean either of such Committee
or the full Board of Directors) has approved and authorized the Company's entry
into this Agreement with the Executive;

      WHEREAS, the Company and Executive desire to amend and restate the
Existing Employment Agreement as set forth herein; and

      NOW, THEREFORE, in consideration of the promises and the mutual covenants
herein contained, the Company and the Executive hereby agree as follows:

      1. Employment. The Company or its subsidiary hereby employs the Executive,
and the Executive hereby accepts employment with the Company or its subsidiary,
upon the terms and subject to the conditions set forth herein.

      2. Term. This Agreement is for the five-year period (the "Term")
commencing on the date first written above (the "Effective Date") and
terminating on the fifth anniversary of the Effective Date, or upon the
Executive's earlier death, disability or other termination of employment
pursuant to Section 10; provided, however, that commencing on the fifth
anniversary of the Effective Date and on each anniversary thereafter the Term
shall automatically be extended for one additional year unless, not later than
90 days prior to any such anniversary, either party hereto shall have notified
the other party hereto that such extension shall not take effect.

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      3. Position. During the Term, the Executive shall serve as the Vice
Chairman of the Company or in such other senior executive position in the
Company as the Executive should approve.

      4. Duties and Reporting Relationship. During the Term, the Executive
shall, on a full time basis, use his skills and render services to the best of
his ability in supervising and conducting the operations of the Company.

      5. Place of Performance. The Executive shall perform his duties and
conduct his business at the principal executive offices of the Company, except
for required travel on the Company's business.

      6. Salary and Annual Bonus.

      (a) Base Salary. The Executive's base salary hereunder shall be $605,000
per year, payable semi-monthly. Commencing on January 1, 2005, 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.

      (b) Annual Bonus. The Board (or if there is a compensation committee of
the Board, the compensation committee) shall provide the Executive with an
annual bonus plan providing the Executive with an opportunity to earn annual
bonus compensation and shall cause the Company to pay to him any earned annual
bonus in addition to his base salary.

      7. Vacation, Holidays and Sick Leave. During the Term, the Executive shall
be entitled to paid vacation, paid holidays and sick leave in accordance with
the Company's standard policies for its senior executive officers.

      8. Business Expenses. The Executive will be reimbursed for all ordinary
and necessary business expenses incurred by him in connection with his
employment upon timely submission by the Executive of receipts and other
documentation as required by the Internal Revenue Code and in conformance with
the Company's normal procedures.

      9. Pension and Welfare Benefits. During the Term, the Executive shall be
eligible to participate fully in all health benefits, insurance programs,
pension and retirement plans and other employee benefit and compensation
arrangements available to senior officers of the Company generally.

      10. Termination of Employment.

      (a) General. The Executive's employment hereunder may be terminated
without any breach of this Agreement only under the following circumstances.

      (b) Death or Disability.

            (i) The Executive's employment hereunder shall automatically
      terminate upon the death of the Executive.
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            (ii) If, as a result of the Executive's incapacity due to physical
      or mental illness, the Executive shall have been absent from his duties
      with the Company for any six (6) months (whether or not consecutive)
      during any twelve (12) month period, the Company may terminate the
      Executive's employment hereunder for any such incapacity (a "Disability").

      (c) Cause. The Company may terminate the Executive's employment hereunder
for Cause. For purposes of this Agreement, "Cause" shall mean (i) the willful
failure or refusal by the Executive to perform his duties hereunder (other than
any such failure resulting from the Executive's incapacity due to physical or
mental illness), which has not ceased within ten (10) days after a written
demand for substantial performance is delivered to the Executive by the Company,
which demand identifies the manner in which the Company believes that the
Executive has not performed such duties, (ii) the willful engaging by the
Executive in misconduct which is materially injurious to the Company, monetarily
or otherwise (including, but not limited to, conduct described in Section 14) or
(iii) the conviction of the Executive of, or the entering of a plea of nolo
contendere by the Executive with respect to, a felony. Notwithstanding the
foregoing, the Executive's employment hereunder shall not be deemed to have been
terminated for Cause unless and until there shall have been delivered to the
Executive a copy of a resolution duly adopted by the affirmative vote of not
less than a majority of the entire membership of the Board at a meeting of the
Board (after written notice to the Executive and a reasonable opportunity for
the Executive, together with the Executive's counsel, to be heard before the
Board), finding that in the good faith opinion of the Board the Executive should
be terminated for cause.

      (d) Termination by the Executive. The Executive shall be entitled to
terminate his employment hereunder (A) for Good Reason or (B) for any other
reason. For purposes of this Agreement, "Good Reason" shall mean, (i) without
the Executive's express written consent, any failure by the Company to comply
with any material provision of this Agreement, which failure has not been cured
within ten (10) days after notice of such noncompliance has been given by the
Executive to the Company or (ii) the occurrence (without the Executive's express
written consent), following a Change in Control during the term of this
Agreement, of any one of the following acts by the Company, or failures by the
Company to act, unless, in the case of any act or failure to act described
below, such act or failure to act is corrected prior to the Date of Termination
specified in the Notice of Termination given in respect thereof:

            (i) any change in the Executive's title, authorities,
      responsibilities (including reporting responsibilities) which, in the
      Executive's reasonable judgment, represents an adverse change from his
      status, title, position or responsibilities (including reporting
      responsibilities) which were in effect immediately prior to the Change in
      Control or from his status, title, position or responsibilities (including
      reporting responsibilities) which were in effect following a Change in
      Control pursuant to the Executive's consent to accept any such change; the
      assignment to him of any duties or work responsibilities which, in his
      reasonable judgment, are inconsistent with such status, title, position or
      work responsibilities; or any removal of the Executive from, or failure to
      reappoint or reelect him to any of such positions, except if any such
      changes are because of Disability, retirement, death or Cause;

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            (ii) a reduction by the Company in the Executive's annual base
      salary as in effect on the date hereof or as the same may be increased
      from time to time except for across-the-board salary reductions similarly
      affecting all senior executives of the Company and all senior executives
      of any Person (as defined in Section 10(h)(i) below) in control of the
      Company; provided in no event shall any such reduction reduce the
      Executive's base salary below $605,000;

            (iii) the relocation of the Executive's office at which he is to
      perform his duties, to a location more than thirty (30) miles from the
      location at which the Executive performed his duties prior to the Change
      in Control, except for required travel on the Company's business to an
      extent substantially consistent with his business travel obligations prior
      to the Change in Control;

            (iv) if the Executive had been based at the Company's principal
      executive offices immediately prior to the Change in Control, the
      relocation of the Company's principal executive offices to a location more
      than 30 miles from the location of such offices immediately prior to the
      Change in Control;

            (v) the failure by the Company, without the Executive's consent, to
      pay to the Executive any portion of the Executive's current compensation,
      or to pay to the Executive any portion of an installment of deferred
      compensation under any deferred compensation program of the Company,
      within seven (7) days of the date such compensation is due;

            (vi) the failure by the Company to continue in effect any
      stock-based and/or cash annual or long-term incentive compensation plan in
      which the Executive participates immediately prior to the Change in
      Control, unless the Executive participates after the Change in Control in
      other comparable plans generally available to senior executives of the
      Company and senior executives of any Person in control of the Company;

            (vii) the failure by the Company to continue to provide the
      Executive with benefits substantially similar in value to the Executive in
      the aggregate to those enjoyed by the Executive under any of the Company's
      pension, life insurance, medical, health and accident, or disability plans
      in which the Executive was participating immediately prior to the Change
      in Control, unless the Executive participates after the Change in Control
      in other comparable benefit plans generally available to senior executives
      of the Company and senior executives of any Person in control of the
      Company;

            (viii) the adverse and substantial alteration of the nature and
      quality of the office space within which the Executive performed his
      duties prior to a Change in Control as well as in the secretarial and
      administrative support provided to the Executive, provided, however, that
      a reasonable alteration of the secretarial or administrative support
      provided to the Executive as a result of reasonable measures implemented
      by the Company to effectuate a cost-reduction or consolidation program
      shall not constitute Good Reason hereunder; or

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            (ix) any purported termination of the Executive's employment which
      is not effected pursuant to a Notice of Termination satisfying the
      requirements of Section 10(f) below; for purposes of this Agreement, no
      such purported termination shall be effective.

      The Executive's continued employment shall not constitute consent to, or a
waiver of rights with respect to, any act or failure to act constituting Good
Reason hereunder.

      (e) Voluntary Resignation. Should the Executive wish to resign from his
position with the Company or terminate his employment for other than Good Reason
during the Term, the Executive shall give sixty (60) days written notice to the
Company, setting forth the reasons and specifying the date as of which his
resignation is to become effective.

      (f) Notice of Termination. Any purported termination of the Executive's
employment by the Company or by the Executive shall be communicated by written
Notice of Termination to the other party hereto in accordance with Section 18.
"Notice of Termination" shall mean a notice that shall indicate the specific
termination provision in this Agreement relied upon and shall set forth in
reasonable detail the facts and circumstances claimed to provide a basis for
termination of the Executive's employment under the provision so indicated.

      (g) Date of Termination. "Date of Termination" shall mean (i) if the
Executive's employment is terminated because of death, the date of the
Executive's death, (ii) if the Executive's employment is terminated for
Disability, the date Notice of Termination is given, or (iii) if the Executive's
employment is terminated pursuant to Subsection (c), (d) or (e) hereof or for
any other reason (other than death or Disability), the date specified in the
Notice of Termination (which, in the case of a termination for Good Reason shall
not be less than fifteen (15) nor more than sixty (60) days from the date such
Notice of Termination is given, and in the case of a termination for any other
reason shall not be less than thirty (30) days (sixty (60) days in the case of a
termination under Subsection (e) hereof) from the date such Notice of
Termination is given); provided, that in the case of a termination for Cause,
nothing herein shall prevent the Company from immediately terminating the
Executive's employment, so long as the Company continues to meet all of its
responsibilities hereunder with respect to payment of salary, benefits and other
obligations during the minimum notice period described in this Subsection (g)
(and for purposes of measuring such obligations, the Date of Termination shall
be deemed to be the end of such minimum notice period).

      (h) Change in Control. For purposes of this Agreement, a Change in Control
of the Company shall have occurred if

            (i) any "Person" (as defined in Section 3(a)(9) of the Securities
      Exchange Act of 1934 (the "Exchange Act") as modified and used in Sections
      13(d) and 14(d) of the Exchange Act (other than (1) the Company or any of
      its subsidiaries, (2) any trustee or other fiduciary holding securities
      under an employee benefit plan of the Company or any of its subsidiaries,
      (3) an underwriter temporarily holding securities pursuant to an offering
      of such securities, (4) any entity owned, directly or indirectly, by the
      stockholders of the Company in substantially the same proportions as their
      ownership of the Company's common stock, (5) any Person that is a
      stockholder of the Company on the date hereof and any affiliates of such
      Person, or (6) Blackstone (as defined in the

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      Company's 2004 Stock Incentive Plan), or any of its affiliates), is or
      becomes the "beneficial owner" (as defined in Rule 13d-3 under the
      Exchange Act), directly or indirectly, of securities of the Company
      representing more than 50% of the combined voting power of the Company's
      then outstanding voting securities;

            (ii) during any period of not more than two consecutive years, not
      including any period prior to the date of this Agreement, individuals who
      at the beginning of such period constitute the Board, and any new director
      (other than a director designated by a person who has entered into an
      agreement with the Company to effect a transaction described in clause
      (i), (iii), or (iv) of this Section 10(h)) whose election by the Board or
      nomination for election by the Company's stockholders was approved by a
      vote of at least two-thirds (2/3) of the directors then still in office
      who either were directors at the beginning of the period or whose election
      or nomination for election was previously so approved, cease for any
      reason to constitute at least a majority thereof;

            (iii) the stockholders of the Company approve a merger or
      consolidation of the Company with any other corporation, other than both
      (A) (1) a merger or consolidation which would result in the voting
      securities of the Company outstanding immediately prior thereto
      continuing, directly or indirectly, to represent (either by remaining
      outstanding or by being converted into voting securities of the surviving
      or parent entity) 50% or more of the combined voting power of the voting
      securities of the Company or such surviving or parent entity outstanding
      immediately after such merger or consolidation or (2) a merger or
      consolidation in which no person acquires 50% or more of the combined
      voting power of the Company's then outstanding securities; and (B)
      immediately after the consummation of such merger or consolidation
      described in clause (A) (1) or (A) (2) above (and for at least 180 days
      thereafter) neither the Company's Chief Executive Officer nor its Chief
      Financial Officer change from the people occupying such positions
      immediately prior to such merger or consolidation except as a result of
      their death or Disability and neither of such officers shall have changed
      prior to such merger or consolidation at the direction of a Person who has
      entered into an agreement with the Company the consummation of which will
      constitute a Change in Control of the Company; or

            (iv) the stockholders of the Company approve (A) a plan of complete
      liquidation of the Company or (B) an agreement for the sale or disposition
      by the Company of all or substantially all of the Company's assets (or any
      transaction having a similar effect).

      For purposes of Section 10(h)(i), 10(h)(ii) and 10(h)(iv)(B) of this
Agreement only, the "Company" shall mean any of Vanguard Health Systems, Inc.,
Vanguard Health Holding Company I, LLC, or Vanguard Health Holding Company II,
LLC; provided that, any reorganization involving solely the "Company" and its
subsidiaries shall not constitute a change in control under this agreement.
Notwithstanding any provision under Section 10(h) of this Agreement, the
transactions contemplated by the Merger Agreement shall not constitute a Change
in Control under this Agreement.

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            (i) Resignation as Member of Board. If the Executive's employment by
      the Company is terminated for any reason, the Executive hereby agrees that
      he shall simultaneously submit his resignation as a member of the Board in
      writing on or before the Date of Termination if the Executive is a member
      of the Board at such time. If the Executive fails to submit such required
      resignation in writing, the provisions of this Subsection 10(i) may be
      deemed by the Company to constitute the Executive's written resignation as
      a member of the Board effective as of the Date of Termination.

            11. Compensation During Disability, Death or Upon Termination.

            (a) During any period that the Executive fails to perform his duties
      hereunder as a result of incapacity due to physical or mental illness
      ("Disability Period"), the Executive shall continue to receive his full
      salary at the rate then in effect for such period until his employment is
      terminated pursuant to Section 10(b)(ii) hereof, provided that payments so
      made to the Executive during the Disability Period shall be reduced by the
      sum of the amounts, if any, payable to the Executive with respect to such
      period under disability benefit plans of the Company or under the Social
      Security disability insurance program, and which amounts were not
      previously applied to reduce any such payment.

            (b) If the Executive's employment is terminated by his death or
      Disability, the Company shall pay (i) any amounts due to the Executive
      under Section 6 through the date of such termination and (ii) all such
      amounts that would have become due to the Executive under Section 6 had
      the Executive's employment hereunder continued until the last day of the
      calendar year in which such termination of employment occurred, in each
      case in accordance with Section 13(b), if applicable.

            (c) If the Executive's employment shall be terminated by the Company
      for Cause or by the Executive for other than Good Reason, the Company
      shall pay the Executive his full salary through the Date of Termination at
      the rate in effect at the time Notice of Termination is given, and the
      Company shall have no further obligations to the Executive under this
      Agreement.

            (d) If (A) following a Change in Control the Company shall terminate
      the Executive's employment in breach of this Agreement, or (B) following a
      Change in Control the Executive shall terminate his employment for Good
      Reason, then

                  (i) the Company shall pay the Executive (x) his full salary
            through the Date of Termination at the rate in effect at the time
            Notice of Termination is given, (y) a pro rata portion of his
            current year annual bonus pursuant to Section 6(b) and (z) all other
            unpaid amounts, if any, to which the Executive is entitled as of the
            Date of Termination under any compensation plan or program of the
            Company, at the time such payments are due;

                  (ii) in lieu of any further salary payments to the Executive
            for periods subsequent to the Date of Termination, the Company shall
            pay as liquidated damages to the Executive an aggregate amount equal
            to the product of (A) the sum of (1) the Executive's annual salary
            rate in effect as of the Date of Termination and (2) the average of
            the annual bonuses actually paid to the Executive by the Company
            with respect to the

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            two fiscal years which immediately precede the year of the Term in
            which the Date of Termination occurs; provided if there was a bonus
            or bonuses paid to the Executive with respect only to one fiscal
            year which immediately precedes the year of the Term in which the
            Date of Termination occurs, then such single year's bonus or bonuses
            shall be utilized in the calculation pursuant to this clause (2) and
            (B) the number three (3);

                  (iii) the Company shall (x) continue coverage for the
            Executive under the Company's life insurance, medical, health,
            disability and similar welfare benefit plans (or, if continued
            coverage is barred under such plans, the Company shall provide to
            the Executive substantially similar benefits) for a period equal to
            the greater of (A) the remainder of the Term and (B) 18 months, and
            (y) provide the benefits which the Executive would have been
            entitled to receive pursuant to any supplemental retirement plan
            maintained by the Company had his employment continued at the rate
            of compensation specified herein for a period equal to the greater
            of (A) the remainder of the Term and (B) 18 months. Benefits
            otherwise receivable by the Executive pursuant to clause (x) of this
            Subsection 11(d)(iii) shall be reduced to the extent comparable
            benefits are actually received by the Executive from a subsequent
            employer during the period during which the Company is required to
            provide such benefits, and the Executive shall report any such
            benefits actually received by him to the Company; and

                  (iv) the payments provided for in this Section 11(d) (other
            than Section 11(d)(iii)) shall be made not later than the fifth day
            following the Date of Termination, provided, however, that if the
            amounts of such payments, and the limitation on such payments set
            forth in Section 15 hereof, cannot be finally determined on or
            before such day, the Company shall pay to the Executive on such day
            an estimate, as determined in good faith by the Company, of the
            minimum amount of such payments to which the Executive is clearly
            entitled and shall pay the remainder of such payments (together with
            interest at the rate provided in section 1274(b)(2)(B) of the Code
            (as defined in Section 15)) as soon as the amount thereof can be
            determined but in no event later than the thirtieth (30th) day after
            the Date of Termination. In the event that the amount of the
            estimated payments exceeds the amount determined by the Company
            within six (6) months after payment to have been due, such excess
            shall be paid by the Executive to the Company, no later than the
            thirtieth (30th) business day after demand by the Company. At the
            time that payments are made under this Section 11(d), the Company
            shall provide the Executive with a written statement setting forth
            the manner in which such payments were calculated and the basis for
            such calculations including, without limitation, any opinions or
            other advice the Company has received from outside counsel, auditors
            or consultants (and any such opinions or advice which are in writing
            shall be attached to the statement).

            (e) If (A) prior to any Change in Control the Company shall
      terminate the Executive's employment in breach of this Agreement or (B)
      prior to any Change in Control the Executive shall terminate his
      employment for Good Reason, then

                  (i) the Company shall pay the Executive (x) his full salary
            through the Date of Termination at the rate in effect at the time
            Notice of Termination is given, (y) a pro rata portion of his
            current year annual bonus pursuant to Section 6(b) and (z) any all
            other

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            unpaid amounts, if any, to which the Executive is entitled as of the
            Date of Termination under any compensation plan or program of the
            Company, at the time such payments are due;

                  (ii) in lieu of any further salary payments to the Executive
            for periods subsequent to the Date of Termination, the Company shall
            pay as liquidated damages to the Executive an aggregate amount equal
            to the product of (A) the sum of (1) the Executive's annual salary
            rate in effect as of the Date of Termination and (2) the average of
            the annual bonuses actually paid to the Executive by the Company
            with respect to the two fiscal years which immediately precede the
            year of the Term in which the Date of Termination occurs; provided
            if there was a bonus or bonuses paid to the Executive with respect
            only to one fiscal year which immediately precedes the year of the
            Term in which the Date of Termination occurs, then such single
            year's bonus or bonuses shall be utilized in the calculation
            pursuant to this clause (2) and (B) the lesser of (x) the number
            three (3) and (y) the greater of (aa) the number of years (including
            partial years) remaining in the Term and (bb) the number two (2);
            such amount to be paid in substantially equal monthly installments
            during the period commencing with the month immediately following
            the month in which the Date of Termination occurs and ending with
            the month corresponding to the end of the Term hereunder; and

                  (iii) the Company shall, at its cost (provided that Executive
            shall continue to be responsible to pay the standard employee
            portion of such cost), (x) continue coverage for the Executive under
            the Company's life insurance, medical, health, disability and
            similar welfare benefit plans (or, if continued coverage is barred
            under such plans, the Company shall provide to the Executive
            substantially similar benefits) for a period equal to the greater of
            (A) the remainder of the Term and (B) 18 months, and (y) provide the
            benefits which the Executive would have been entitled to receive
            pursuant to any supplemental retirement plan maintained by the
            Company had his employment continued at the rate of compensation
            specified herein for a period equal to the greater of (A) the
            remainder of the Term and (B) 18 months. Benefits otherwise
            receivable by the Executive pursuant to clause (x) of this
            Subsection 11(e)(iii) shall be reduced to the extent comparable
            benefits are actually received by the Executive from a subsequent
            employer during the period during which the Company is required to
            provide such benefits, and the Executive shall report any such
            benefits actually received by him to the Company.

            (f) The Executive shall not be required to mitigate the amount of
      any payment provided for in this Section 11 by seeking other employment or
      otherwise, and, except as provided in Sections 11(d) and 11(e) hereof, the
      amount of any payment or benefit provided for in this Section 11 shall (i)
      not be reduced by any compensation earned by the Executive as the result
      of employment by another employer or by retirement benefits and (ii) be
      the sole amount due to the Executive from the Company upon such
      termination of employment, the Executive hereby waiving any claim for
      other compensation or related damages (whether consequential, punitive or
      other) as a result of such termination.

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      12. Representations.

      (a) The Company represents and warrants that this Agreement has been
authorized by all necessary corporate action of the Company and is a valid and
binding agreement of the Company enforceable against it in accordance with its
terms.

      (b) The Executive represents and warrants that he is not a party to any
agreement or instrument which would prevent him from entering into or performing
his duties in any way under this Agreement.

      13. Successors; Binding Agreement.

      (a) The Company will require any successor (whether direct or indirect, by
purchase, merger, consolidation or otherwise) to all or substantially all of the
business and/or assets of the Company to expressly assume and agree to perform
this Agreement in the same manner and to the same extent that the Company would
be required to perform it if no such succession had taken place.

      (b) This Agreement is a personal contract and the rights and interests of
the Executive hereunder may not be sold, transferred, assigned, pledged,
encumbered, or hypothecated by him, except as otherwise expressly permitted by
the provisions of this Agreement. This Agreement shall inure to the benefit of
and be enforceable by the Executive and his personal or legal representatives,
executors, administrators, successors, heirs, distributees, devisees and
legatees. If the Executive should die while any amount would still be payable to
him hereunder had the Executive continued to live, all such amounts, unless
otherwise provided herein, shall be paid in accordance with the terms of this
Agreement to his devisee, legatee or other designee or, if there is no such
designee, to his estate.

      14. Confidentiality and Non-Competition Covenants.

      (a) The Executive covenants and agrees that he will not at any time during
and after the end of the Term, directly or indirectly, use for his own account,
or disclose to any person, firm or corporation, other than authorized officers,
directors and employees of the Company or its subsidiaries, Confidential
Information (as hereinafter defined) of the Company. As used herein,
"Confidential Information" of the Company means information of any kind, nature
or description which is disclosed to or otherwise known to the Executive as a
direct or indirect consequence of his association with the Company, which
information is not generally known to the public or in the businesses in which
the Company is engaged or which information relates to specific investment
opportunities within the scope of the Company's business which were considered
by the Executive or the Company during the term of this Agreement. During the
Term and for a period of two years following the termination of the Executive's
employment, the Executive shall not induce any employee of the Company or its
subsidiaries to terminate his or her employment by the Company or its
subsidiaries in order to obtain employment by any person, firm or corporation
affiliated with the Executive.

      (b) The Executive covenants and agrees that while the Executive remains
employed by the Company or its subsidiary and for a period of two (2) years
following the termination of the Executive's employment, the Executive shall
not, directly or indirectly, own any interest in,

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operate, join, control, or participate as a partner, director, principal,
officer, or agent of, enter into the employment of, act as a consultant to, or
perform any services for any entity which is a hospital system or is in the
hospital or hospital management business. Notwithstanding anything herein to the
contrary, (1) the foregoing provisions of this Section 14(b) shall not prevent
the Executive from (x) acquiring securities representing not more than 5% of the
outstanding voting securities of any publicly held corporation or (y) working as
an accountant or an attorney for a law or accounting firm and (2) the foregoing
provisions of this Section 14(b) shall not be applicable to a termination of the
Executive's employment (i) by the Company or (ii) by the Executive for Good
Reason.

      15. Prohibition on Parachute Payments.

      (a) Notwithstanding any other provisions of this Agreement, in the event
that any payment or benefit received or to be received by the Executive in
connection with a Change in Control of the Company or the termination of the
Executive's employment (whether pursuant to the terms of this Agreement or any
other plan, arrangement or agreement with the Company, any Person whose actions
result in a Change in Control or any Person affiliated with the Company or such
Person) (all such payments and benefits, including, without limitation, base
salary and bonus payments, being hereinafter called "Total Payments") would not
be deductible (in whole or in part), by the Company, an affiliate or any Person
making such payment or providing such benefit as a result of section 280G of the
Internal Revenue Code of 1986, as amended (the "Code"), then, to the extent
necessary to make such portion of the Total Payments deductible (and after
taking into account any reduction in the Total Payments provided by reason of
section 280G of the Code in such other plan, arrangement or agreement), (A) the
cash portion of the Total Payments shall first be reduced (if necessary, to
zero), and (B) all other non- cash payments by the Company to the Executive
shall next be reduced (if necessary, to zero). For purposes of this limitation
(i) no portion of the Total Payments the receipt or enjoyment of which the
Executive shall have effectively waived in writing prior to the Date of
Termination shall be taken into account, (ii) no portion of the Total Payments
shall be taken into account which in the opinion of tax counsel selected by the
Company's independent auditors and reasonably acceptable to the Executive does
not constitute a "parachute payment" within the meaning of section 280G(b)(2) of
the Code, including by reason of section 280G(b)(4)(A) of the Code, (iii) such
payments shall be reduced only to the extent necessary so that the Total
Payments (other than those referred to in clauses (i) or (ii)) in their entirety
constitute reasonable compensation for services actually rendered within the
meaning of section 280G(b)(4)(B) of the Code or are otherwise not subject to
disallowance as deductions, in the opinion of the tax counsel referred to in
clause (ii); and (iv) the value of any non-cash benefit or any deferred payment
or benefit included in the Total Payments shall be determined by the Company's
independent auditors in accordance with the principles of sections 280G(d)(3)
and (4) of the Code.

      (b) If it is established pursuant to a final determination of a court or
an Internal Revenue Service proceeding that, notwithstanding the good faith of
the Executive and the Company in applying the terms of this Section 15, the
aggregate "parachute payments" paid to or for the Executive's benefit are in an
amount that would result in any portion of such "parachute payments" not being
deductible by reason of section 280G of the Code, then the Executive shall have
an obligation to pay the Company upon demand an amount equal to the excess of
the aggregate "parachute payments" paid to or for the Executive's benefit over
the aggregate

<PAGE>
                                                                              12

"parachute payments" that could have been paid to or for the Executive's benefit
without any portion of such "parachute payments" not being deductible by reason
of section 280G of the Code.

      16. Entire Agreement. This Agreement contains all the understandings
between the parties hereto pertaining to the matters referred to herein, and on
the Effective Date shall supersede all undertakings and agreements, whether oral
or in writing, previously entered into by them with respect thereto. The
Executive represents that, in executing this Agreement, he does not rely and has
not relied upon any representation or statement not set forth herein made by the
Company with regard to the subject matter, bases or effect of this Agreement or
otherwise.

      17. Amendment or Modification, Waiver. No provision of this Agreement may
be amended or waived unless such amendment or waiver is agreed to in writing,
signed by the Executive and by a duly authorized officer of the Company. No
waiver by any party hereto of any breach by another party hereto of any
condition or provision of this Agreement to be performed by such other party
shall be deemed a waiver of a similar or dissimilar condition or provision at
the same time, any prior time or any subsequent time.

      18. Notices. Any notice to be given hereunder shall be in writing and
shall be deemed given when delivered personally, sent by courier or telecopy or
registered or certified mail, postage prepaid, return receipt requested,
addressed to the party concerned at the address indicated below or to such other
address as such party may subsequently give notice of hereunder in writing:

     To Executive at:         Keith B. Pitts
                              20 Burton Hills Blvd.
                              Suite 100
                              Nashville, Tennessee 37215

     To the Company at:       Vanguard Health Systems, Inc.
                              20 Burton Hills Blvd.
                              Suite 100
                              Nashville, TN 37215
                              Attention: General Counsel
                              Telecopy: (615) 665-6197

                              with a copy to:

                              VHS Holdings LLC
                              c/o Blackstone Management Associates IV LLC
                              345 Park Avenue
                              New York, NY 10154
                              Attention: Neil Simpkins

                              and a copy to:

                              Simpson Thacher & Bartlett LLP
                              425 Lexington Avenue

<PAGE>
                                                                              13

                              New York, NY 10017-3954
                              Attention: Brian Robbins

      Any notice delivered personally or by courier under this Section 18 shall
be deemed given on the date delivered and any notice sent by telecopy or
registered or certified mail, postage prepaid, return receipt requested, shall
be deemed given on the date telecopied or mailed.

      19. Severability. If any provision of this Agreement or the application of
any such provision to any party or circumstances shall be determined by any
court of competent jurisdiction to be invalid and unenforceable to any extent,
the remainder of this Agreement or the application of such provision to such
person or circumstances other than those to which it is so determined to be
invalid and unenforceable, shall not be affected thereby, and each provision
hereof shall be validated and shall be enforced to the fullest extent permitted
by law.

      20. Survivorship. The respective rights and obligations of the parties
hereunder shall survive any termination of this Agreement to the extent
necessary to the intended preservation of such rights and obligations.

      21. Governing Law; Attorney's Fees.

      (a) This Agreement shall be governed by and construed in accordance with
the laws of the State of Tennessee, without regard to its conflicts of laws
principles.

      (b) The prevailing party in any dispute arising out of this Agreement
shall be entitled to be paid its reasonable attorney's fees incurred in
connection with such dispute from the other party to such dispute.

      22. Headings. All descriptive headings of sections and paragraphs in this
Agreement are intended solely for convenience, and no provision of this
Agreement is to be construed by reference to the heading of any section or
paragraph.

      23. Withholdings. All payments to the Executive under this Agreement shall
be reduced by all applicable withholding required by federal, state or local tax
laws.

      24. Counterparts. This Agreement may be executed in counterparts, each of
which shall be deemed an original, but all of which together shall constitute
one and the same instrument.

               [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK.]

<PAGE>
                                                                              14

      IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the date first above written.

                                    VANGUARD HEALTH SYSTEMS, INC.

                                    By: /s/ Charles N. Martin, Jr.
                                       ---------------------------------
                                        Charles N. Martin, Jr.
                                        Chairman of the Board and
                                        Chief Executive Officer

                                    THE EXECUTIVE

                                      /s/ Keith B. Pitts
                                      --------------------------------
                                      Keith B. Pitts<PAGE>

                                                                   EXHIBIT 10.16

                              AMENDED AND RESTATED
                         SEVERANCE PROTECTION AGREEMENT

      THIS AMENDED AND RESTATED SEVERANCE AGREEMENT (this "AGREEMENT") dated as
of September 23, 2004, is made by and between Vanguard Health Systems, Inc., a
Delaware corporation (the "COMPANY"), and Kent H. Wallace (the "EXECUTIVE").

      WHERAS, the Company and the Executive executed a severance protection
agreement (the "EXISTING PROTECTION AGREEMENT") dated as of February 6, 2003;

      WHEREAS, the Company has entered into an agreement and plan of merger by
and among VHS Holdings LLC, Health Systems Acquisition Corp. and the Company,
dated as of July 23, 2004 (the "MERGER AGREEMENT") whereby the Health Systems
Corp. will merge into the Company with the Company as the surviving corporation;

      WHEREAS, the Company considers it essential to the best interests of its
shareholders to foster the continuous employment of key management personnel;
and

      WHEREAS, the Board of the Company (the "BOARD") recognizes that the
possibility of a Change in Control (as defined in the last Section hereof)
exists and that such possibility, and the uncertainty and questions which it may
raise among management, may result in the departure or distraction of management
personnel to the detriment of the Company and its shareholders; and

      WHEREAS, the Board has determined that appropriate steps should be taken
to reinforce and encourage the continued attention and dedication of members of
the Company's management, including the Executive, to their assigned duties
without distraction in the face of potentially disturbing circumstances arising
from the possibility of a Change in Control;

      WHEREAS, the Company and the Executive desire to amend and restate the
Existing Protection Agreement as set forth herein; and

      NOW THEREFORE, in consideration of the promises and the mutual covenants
herein contained, the Company and the Executive hereby agree as follows:

      1. Defined Terms. Except for those terms defined above, the definition of
capitalized terms used in this Agreement is provided in the last Section hereof.

      2. Term of Agreement. This Agreement shall commence on the date hereof and
shall continue in effect through December 31, 2004; provided, however, that
commencing on January 1, 2005 and each January 1 thereafter, the term of this
Agreement shall automatically be extended for one additional year unless, not
later than September 30 of the preceding year, the Company shall have given
notice not to extend this Agreement; and provided, further, however, that the
Company agrees that it shall not give such notice prior to the third anniversary
of the

                                      -1-
<PAGE>

date first written above; and provided further, however, that if a Change in
Control shall have occurred during the term of this Agreement, this Agreement
shall continue in effect for a period of not less than thirty-six (36) months
beyond the month in which such Change in Control occurred. Furthermore, if the
Executive's employment with the Company shall be terminated prior to a Change in
Control, this Agreement shall automatically expire.

      3. Company's Covenants Summarized. In order to induce the Executive to
remain in the employ of the Company and in consideration of the Executive's
covenants set forth in Section 4 hereof, the Company agrees, under the
conditions described herein, to pay the Executive the Severance Payments
described in Section 6.1 hereof and the other payments and benefits described
herein in the event the Executive's employment with the Company is terminated
following a Change in Control and during the term of this Agreement. No amount
or benefit shall be payable under this Agreement unless there shall have been
(or, under the terms hereof, there shall be deemed to have been) a termination
of the Executive's employment with the Company following a Change in Control.
This Agreement shall not be construed as creating an express or implied contract
of employment and, except as otherwise agreed in writing between the Executive
and the Company, the Executive shall not have any right to be retained in the
employ of the Company.

      4. The Executive's Covenants. The Executive agrees that, subject to the
terms and conditions of this Agreement, in the event of a Potential Change in
Control during the term of this Agreement, the Executive will remain in the
employ of the Company until the earliest of (i) a date which is six (6) months
from the date of such Potential Change in Control, (ii) the date of a Change in
Control, (iii) the date of termination by the Executive of the Executive's
employment for Good Reason (determined by treating the Potential Change in
Control as a Change in Control in applying the definition of Good Reason), or by
reason of death, Disability or Retirement, or (iv) the termination by the
Company of the Executive's employment for any reason.

      5. Compensation Other Than Severance Payments.

            5.1 Following a Change in Control and during the term of this
      Agreement, during any period that the Executive fails to perform the
      Executive's full-time duties with the Company as a result of incapacity
      due to physical or mental illness, the Company shall pay the Executive's
      full salary to the Executive at the rate in effect at the commencement of
      any such period, together with all compensation and benefits payable to
      the Executive under the terms of any compensation or benefit plan, program
      or arrangement maintained by the Company during such period, until the
      Executive's employment is terminated by the Company for Disability.

            5.2 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay the Executive's full salary to the Executive through the
      Date of Termination at the rate in effect at the time the Notice of
      Termination is given, together with all compensation and benefits payable
      to the Executive through the Date of Termination

                                      -2-
<PAGE>

      under the terms of any compensation or benefit plan, program or
      arrangement maintained by the Company during such period.

            5.3 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay to the Executive a lump sum amount, in cash, equal to
      the sum of (i) any incentive compensation which has been allocated or
      awarded to the Executive for a completed fiscal year or other measuring
      period preceding the Date of Termination under any incentive plan but has
      not yet been paid (pursuant to Section 5.2 hereof or otherwise), and (ii)
      a pro rata portion to the Date of Termination of the value of any
      contingent incentive compensation award to the Executive for all
      uncompleted periods under the plan for the year (or other measuring
      period) in which the Date of Termination occurs calculated by multiplying
      the target amount the Executive could have earned under such plan by a
      fraction, the numerator of which is the number of full months the
      Executive was employed by the Company during the fiscal year of the
      Company in which the Date of Termination occurs and the denominator of
      which is 12.

            5.4 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay the Executive's normal post-termination compensation and
      benefits to the Executive as such payments become due. Such
      post-termination compensation and benefits shall be determined under, and
      paid in accordance with the provisions of, the Company's compensation or
      benefit plans, programs and arrangements.

      6. Severance Payments.

            6.1 Subject to Section 6.2 hereof, the Company shall pay the
      Executive the payments described in this Section 6.1 (the "SEVERANCE
      PAYMENTS") upon the termination of the Executive's employment following a
      Change in Control and during the term of this Agreement, in addition to
      the payments and benefits described in Section 5 hereof, unless such
      termination is (i) by the Company for Cause, (ii) by reason of death,
      Disability or Retirement, or (iii) by the Executive without Good Reason.
      The Executive's employment shall be deemed to have been terminated
      following a Change in Control by the Company without Cause or by the
      Executive with Good Reason if the Executive's employment is terminated
      prior to a Change in Control without Cause at the direction of a Person
      who (i) has entered into an agreement with the Company the consummation of
      which will constitute a Change in Control or (ii) has caused a Potential
      Change in Control to occur, or if the Executive terminates his employment
      with Good Reason prior to a Change in Control (determined by treating a
      Potential Change in Control as a Change in Control in applying the
      definition of Good Reason) if the circumstance or event which constitutes
      Good Reason occurs at the direction of such Person.

                  (a) In lieu of any further salary payments to the Executive
            for periods subsequent to the Date of Termination and in lieu of any
            severance benefit

                                      -3-
<PAGE>

            otherwise payable to the Executive, the Company shall pay to the
            Executive a lump sum severance payment, in cash, equal to 250% of
            the sum of (i) the higher of the Executive's annual base salary in
            effect immediately prior to the occurrence of the event or
            circumstance upon which the Notice of Termination is based or in
            effect immediately prior to the Change in Control, and (ii) the
            higher of the target amount which the Executive could have earned
            under the Company's annual incentive plan in the year in which the
            Date of Termination occurs or such target amount in the year in
            which the Change in Control occurs.

                  (b) For an eighteen (18) month period after the Date of
            Termination, the Company shall, at its cost (provided that Executive
            shall continue to be responsible to pay the standard employee
            portion of such cost), arrange to provide the Executive with life,
            disability, accident, health and dental insurance benefits
            substantially similar to those which the Executive is receiving
            immediately prior to the Notice of Termination (without giving
            effect to any reduction in such benefits subsequent to a Change in
            Control which reduction constitutes Good Reason). Benefits otherwise
            receivable by the Executive pursuant to this Section 6.1(b) shall be
            reduced to the extent comparable benefits are actually received by
            or made available to the Executive by a new employer of the
            Executive without cost during the eighteen (18) month period
            following the Executive's termination of employment (and any such
            benefits actually received by the Executive shall be reported to the
            Company by the Executive). If the benefits provided to the Executive
            under this Section 6.1(b) shall result in a decrease, pursuant to
            Section 6.2, in the Severance Payments and these Section 6.1(b)
            benefits are thereafter reduced pursuant to the immediately
            preceding sentence because of the receipt of comparable benefits,
            the Company shall, at the time of such reduction, pay to the
            Executive the lesser of (A) the amount of the decrease made in the
            Severance Payments pursuant to Section 6.2, or (B) the maximum
            amount which can be paid to the Executive without being, or causing
            any other payment to be, nondeductible by reason of Section 280G of
            the Code.

            6.2 Notwithstanding any other provisions of this Agreement (except
      the provisions of Section 6.5 below), in the event that any payment or
      benefit received or to be received by the Executive in connection with a
      Change in Control or the termination of the Executive's employment
      (whether pursuant to the terms of this Agreement or any other plan,
      arrangement or agreement with the Company, any Person whose actions result
      in a Change in Control or any Person affiliated with the Company or such
      Person) (all such payments and benefits, including the Severance Payments,
      being hereinafter called "TOTAL PAYMENTS") would not be deductible (in
      whole or part), by the Company, an affiliate or any Person making such
      payment or providing such benefit as a result of Section 280G of the Code,
      then, to the extent necessary to make such portion of the Total Payments
      deductible (and after taking into account any reduction in the Total
      Payments provided by reason of Section 280G of the Code in such other
      plan, arrangement or agreement), (A) the cash Severance Payments shall
      first be reduced (if necessary, to zero), and (B) all other non-cash
      Severance Payments shall next be reduced (if necessary,

                                      -4-
<PAGE>

      to zero). For purposes of this limitation, (i) no portion of the Total
      Payments the receipt or enjoyment of which the Executive shall have
      effectively waived in writing prior to the Date of Termination shall be
      taken into account, (ii) no portion of the Total Payments shall be taken
      into account which in the opinion of tax counsel selected by the Company's
      independent auditors and reasonably acceptable to the Executive does not
      constitute a "PARACHUTE PAYMENT" within the meaning of Section 280G(b)(2)
      of the Code, including by reason of Section 280G(b)(4)(A) of the Code,
      (iii) the Severance Payments shall be reduced only to the extent necessary
      so that the Total Payments (other than those referred to in clauses (i) or
      (ii)) in their entirety constitute reasonable compensation for services
      actually rendered within the meaning of Section 280G(b)(4)(B) of the Code
      or are otherwise not subject to disallowance as deductions, in the opinion
      of the tax counsel referred to in clause (ii); and (iv) the value of any
      non-cash benefit or any deferred payment or benefit included in the Total
      Payments shall be determined by the Company's independent auditors in
      accordance with the principles of Sections 280G(d)(3) and (4) of the Code.

            If it is established pursuant to a final determination of a court or
      an Internal Revenue Service proceeding that, notwithstanding the good
      faith of the Executive and the Company in applying the terms of this
      Section 6.2, the aggregate "parachute payments" paid to or for the
      Executive's benefit are in an amount that would result in any portion of
      such "parachute payments" not being deductible by reason of Section 280G
      of the Code, then the Executive shall have an obligation to pay the
      Company upon demand an amount equal to the excess of the aggregate
      "parachute payments" paid to or for the Executive's benefit over the
      aggregate "parachute payments" that could have been paid to or for the
      Executive's benefit without any portion of such "parachute payments" not
      being deductible by reason of Section 280G of the Code.

            6.3 The payments provided for in Section 6.1 (other than Section
      6.1(b)) hereof shall be made not later than the fifth day following the
      Date of Termination, provided, however, that if the amounts of such
      payments, and the limitation on such payments set forth in Section 6.2
      hereof, cannot be finally determined on or before such day, the Company
      shall pay to the Executive on such day an estimate, as determined in good
      faith by the Company, of the minimum amount of such payments to which the
      Executive is clearly entitled and shall pay the remainder of such payments
      (together with interest at the rate provided in Section 1274(b)(2)(B) of
      the Code) as soon as the amount thereof can be determined but in no event
      later than the thirtieth (30th) day after the Date of Termination. In the
      event that the amount of the estimated payments exceeds the amount
      determined by the Company within six (6) months after payment to have been
      due, such excess shall be paid by the Executive to the Company, no later
      than the thirtieth (30th) business day after demand by the Company. At the
      time that payments are made under this Section, the Company shall provide
      the Executive with a written statement setting forth the manner in which
      such payments were calculated and the basis for such calculations
      including, without limitation, any opinions or other advice the Company
      has received from outside counsel, auditors or consultants (and any such
      opinions or advice which are in writing shall be attached to the
      statement).

                                      -5-
<PAGE>

            6.4 Following a Change in Control (or a termination described in the
      second sentence of Section 6.1), the Company also shall pay to the
      Executive all legal fees and related expenses (including costs of experts,
      evidence and counsel) incurred by the Executive as a result of any dispute
      in connection with a termination of the Executive's employment, whether or
      not such dispute is resolved in the Executive's favor, but only if the
      dispute is pursued by the Executive in good faith (including all such fees
      and expenses, if any, incurred in respect of a dispute relating to any
      such termination or in the Executive seeking in good faith to obtain or
      enforce any benefit or right provided by this Agreement (or by any other
      plan or arrangement maintained by the Company under which the Executive is
      or may be entitled to receive benefits) or in connection with any tax
      audit or proceeding to the extent attributable to the application of
      Section 4999 of the Code to any payment or benefit provided hereunder).
      Such payments shall be made to the Executive within five (5) business days
      after delivery of the Executive's written requests for payment accompanied
      by evidence of fees and expenses incurred.

      7. Termination Procedures and Compensation During Dispute.

            7.1 Notice of Termination. After a Change in Control and during the
      term of this Agreement, any purported termination of the Executive's
      employment (other than by reason of death) shall be communicated by
      written Notice of Termination from one party hereto to the other party
      hereto in accordance with Section 10 hereof. For purposes of this
      Agreement, a "NOTICE OF TERMINATION" shall mean a notice which shall
      indicate the specific termination provision or provisions in this
      Agreement relied upon and shall set forth in reasonable detail the facts
      and circumstances claimed to provide a basis for termination of the
      Executive's employment under the provision so indicated.

            7.2 Date of Termination. "DATE OF TERMINATION", with respect to any
      purported termination of the Executive's employment after a Change in
      Control and during the term of this Agreement, shall mean (i) if the
      Executive's employment is terminated for Disability, thirty (30) days
      after Notice of Termination is given (provided that the Executive shall
      not have returned to the full-time performance of the Executive's duties
      during such thirty (30) day period), and (ii) if the Executive's
      employment is terminated for any other reason, the date specified in the
      Notice of Termination (which, in the case of a termination by the Company,
      shall not be less than thirty (30) days (except in the case of a
      termination for Cause) and, in the case of a termination by the Executive,
      shall not be less than fifteen (15) days nor more than sixty (60) days,
      respectively, from the date such Notice of Termination is given);
      provided, that in the case of a termination for Cause, nothing herein
      shall prevent the Company from immediately terminating the Executive's
      employment, so long as the Company continues to meet all of its
      responsibilities hereunder with respect to payment of salary, benefits and
      other obligations during the minimum notice period described in this
      Section 7.2 (and for purposes of measuring such obligations, the Date of
      Termination shall be deemed to be the end of such minimum notice period).

                                      -6-
<PAGE>

            7.3 Dispute Concerning Termination. If within fifteen (15) days
      after any Notice of Termination is given, the party receiving such Notice
      of Termination notifies the other party that a dispute exists concerning
      the termination, the dispute shall be resolved promptly, either by mutual
      written agreement of the parties or by a final court judgment or order.
      Any court action brought by a party to this Agreement shall be brought and
      maintained in a court of competent jurisdiction in Davidson County, in the
      State of Tennessee, and the parties hereto hereby consent to the
      jurisdiction of such courts.

            7.4 Interest After Dispute Settled. If a purported termination
      occurs following a Change in Control and during the term of this
      Agreement, and such termination is disputed in accordance with Section 7.3
      hereof, then if such dispute is resolved by payment to the Executive of
      any cash payment, the Company shall in addition pay the Executive interest
      at 10% per annum on all such cash ultimately paid to the Executive as a
      result of settlement of any such dispute from the Date of Termination.

      8. No Mitigation. The Company agrees that, if the Executive's employment
by the Company is terminated during the term of this Agreement, the Executive is
not required to seek other employment or to attempt in any way to reduce any
amounts payable to the Executive by the Company pursuant to Section 6. Further,
the amount of any payment or benefit provided for in Section 6 (other than
Section 6.1(b)) shall not be reduced by any compensation earned by the Executive
as the result of employment by another employer, by retirement benefits, by
offset against any amount claimed to be owed by the Executive to the Company, or
otherwise.

      9. Successors; Binding Agreement.

            9.1 In addition to any obligations imposed by law upon any successor
      to the Company, the Company will require any successor (whether direct or
      indirect, by purchase, merger, consolidation or otherwise) to all or
      substantially all of the business and/or assets of the Company (the
      "SUCCESSOR") to expressly assume and agree to perform this Agreement in
      the same manner and to the same extent that the Company would be required
      to perform it if no such succession had taken place; provided if the
      Company is acquired by merger with a subsidiary of a Person, then such
      Person shall be the Successor unless such Person principally does its
      hospital management business in such subsidiary or in another subsidiary
      of such Person in which case the subsidiary principally doing the hospital
      management company business of the Person shall be the Successor. Failure
      of the Company to obtain such assumption and agreement prior to the
      effectiveness of any such succession, after notice by the Executive to the
      Company and, if practicable, a reasonable opportunity to cure such
      failure, shall be a breach of this Agreement and shall entitle the
      Executive to compensation from the Company in the same amount and on the
      same terms as the Executive would be entitled to hereunder if the
      Executive were to terminate the Executive's employment for Good Reason
      after a Change in Control, except that, for purposes of implementing the
      foregoing, the date on which any such succession becomes effective shall
      be deemed the Date of Termination.

                                      -7-
<PAGE>

            9.2 This Agreement shall inure to the benefit of and be enforceable
      by the Executive's personal or legal representatives, executors,
      administrators, successors, heirs, distributees, devisees and legatees. If
      the Executive shall die while any amount would still be payable to the
      Executive hereunder if the Executive had continued to live, all such
      amounts, unless otherwise provided herein, shall be paid in accordance
      with the terms of this Agreement to the executors, personal
      representatives or administrators of the Executive's estate.

      10. Notices. For the purpose of this Agreement, notices and all other
communications provided for in the Agreement shall be in writing and shall be
deemed to have been duly given when personally delivered or when mailed by
United States certified mail, return receipt requested, postage prepaid,
addressed to the respective addresses set forth below, or to such other address
as either party may have furnished to the other in writing in accordance
herewith, except that notice of change of address shall be effective only upon
actual receipt:

                  To the Company:

                  Vanguard Health Systems, Inc.
                  20 Burton Hills Boulevard
                  Suite 100
                  Nashville, TN  37215
                  Attention: Chief Executive Officer

                  with a copy to:

                  VHS Holdings LLC
                  c/o Blackstone Management Associates IV LLC
                  345 Park Avenue
                  New York, NY 10154
                  Attention: Neil Simpkins

                  and a copy to:

                  Simpson Thacher & Bartlett LLP
                  425 Lexington Avenue
                  New York, NY 10017-3954
                  Attention: Brian Robbins

                  To the Executive:

                  Kent H. Wallace
                  20 Burton Hills Boulevard
                  Suite 100
                  Nashville, TN  37215

                                      -8-
<PAGE>

      11. Miscellaneous. No provision of this Agreement may be modified, waived
or discharged (collectively a "WAIVER") unless the Waiver is agreed to in
writing and signed by the Executive and an officer of the Company and sets forth
in reasonable detail the facts and circumstances which are the subject of the
Waiver. No waiver by either party hereto at any time of any breach by the other
party hereto of, or compliance with, any condition or provision of this
Agreement to be performed by such other party shall be deemed a waiver of
similar or dissimilar provisions or conditions at the same or at any prior or
subsequent time. No agreements or representations, oral or otherwise, express or
implied, with respect to the subject matter hereof have been made by either
party which are not expressly set forth in this Agreement. The validity,
interpretation, construction and performance of this Agreement shall be governed
by the laws of the State of Tennessee, without regard to such state's conflict
of laws rules. All references to sections of the Exchange Act or the Code shall
be deemed also to refer to any successor provisions to such sections. Any
payments provided for hereunder shall be paid net of any applicable withholding
required under federal, state or local law and any additional withholding to
which the Executive has agreed. The obligations of the Company and the Executive
under Sections 6 and 7 shall survive the expiration of the term of this
Agreement.

      12. Validity. The invalidity or unenforceability or any provision of this
Agreement shall not affect the validity or enforceability of any other provision
of this Agreement, which shall remain in full force and effect.

      13. Counterparts. This Agreement may be executed in several counterparts,
each of which shall be deemed to be an original but all of which together will
constitute one and the same instrument.

      14. Definitions. For purposes of this Agreement, the following terms shall
have the meanings indicated below:

            14.1 "BENEFICIAL OWNER" shall have the meaning defined in Rule 13d-3
      under the Exchange Act.

            14.2 "CAUSE" for termination by the Company of the Executive's
      employment, after any Change in Control, shall mean (i) the conviction of
      the Executive, by a court of competent jurisdiction and following the
      exhaustion of all possible appeals, of a criminal act classified as a
      felony or involving moral turpitude, (ii) the willful and continued
      failure by the Executive to substantially perform the Executive's duties
      with the Company (other than any such failure resulting from the
      Executive's incapacity due to physical or mental illness or any such
      actual or anticipated failure after the issuance of a Notice of
      Termination for Good Reason by the Executive pursuant to Section 7.1)
      after a written demand for substantial performance is delivered to the
      Executive by the Company, which demand specifically identifies the manner
      in which the Company believes that the Executive has not substantially
      performed the Executive's duties, or (iii) the willful engaging by the
      Executive in conduct which is demonstrably and materially injurious to the
      Company or its subsidiaries, monetarily or otherwise. For purposes of
      clauses (ii) and (iii) of this definition, no act, or failure to act, on
      the Executive's part

                                      -9-
<PAGE>

      shall be deemed "willful" unless done, or omitted to be done, by the
      Executive not in good faith and without reasonable belief that the
      Executive's act, or failure to act, was in the best interest of the
      Company.

            14.3 "BOARD" shall mean the Board of Directors of the Company.

            14.4 A "CHANGE IN CONTROL" shall be deemed to have occurred if the
      conditions set forth in any one of the following paragraphs shall have
      been satisfied:

                  (a) any Person is or becomes the Beneficial Owner, directly or
            indirectly, of securities of the Company representing more than 50%
            of the combined voting power of the Company's then outstanding
            voting securities; or

                  (b) during any period of not more than two consecutive years
            (not including any period prior to the execution of this Agreement),
            individuals who at the beginning of such period constitute the
            Board, and any new director (other than a director designated by a
            Person who has entered into an agreement with the Company to effect
            a transaction described in clause (a), (c) or (d) of this paragraph)
            whose election by the Board or nomination for election by the
            Company's shareholders was approved by a vote of at least two-thirds
            (2/3) of the directors then still in office who either were
            directors at the beginning of the period or whose election or
            nomination for election was previously so approved, cease for any
            reason to constitute at least a majority thereof; or

                  (c) the shareholders of the Company approve a merger or
            consolidation of the Company with any other corporation, other than
            both (A) (i) a merger or consolidation which would result in the
            voting securities of the Company outstanding immediately prior
            thereto continuing, directly or indirectly, to represent (either by
            remaining outstanding or by being converted into voting securities
            of the surviving or parent entity), 50% or more of the combined
            voting power of the voting securities of the Company or such
            surviving or parent entity outstanding immediately after such merger
            or consolidation, or (ii) a merger or consolidation in which no
            Person acquires 50% or more of the combined voting power of the
            Company's then outstanding securities; and (B) immediately after the
            consummation of such merger or consolidation described in clause
            (A)(i) or (A)(ii) above (and for at least 180 days thereafter) any
            one of the Company's Chief Executive Officer, Chief Operating
            Officer and Chief Financial Officer do not change from the people
            occupying such positions immediately prior to such merger or
            consolidation except as a result of their death or Disability and
            none of such officers shall have changed prior to such merger or
            consolidation at the direction of a Person who has entered into an
            agreement with the Company the consummation of which will constitute
            a Change in Control or who has caused a Potential Change in Control
            to occur; or

                                      -10-
<PAGE>

                  (d) the shareholders of the Company approve (A) a plan of
            complete liquidation of the Company or (B) an agreement for the sale
            or disposition by the Company of all or substantially all the
            Company's assets (or other transaction having a similar effect); or

                  (e) any Potential Change in Control occurs and the Company
            within one (1) year thereafter gives notice to the Executive not to
            extend this Agreement as provided in Section 2.

      For purposes of Section 14.4(a), 14.4(c), and 14.4(d)(B) of this Agreement
      only, the "Company" shall mean any of Vanguard Health Systems, Inc.,
      Vanguard Health Holding Company I, LLC, or Vanguard Health Holding Company
      II, LLC; provided that, any reorganization involving solely the "Company"
      and its subsidiaries shall not constitute a change in control under this
      agreement. Notwithstanding any provision under Section 14.4 of this
      Agreement, a Change in Control shall not include (A) any transaction where
      (i) all of the Company's Chief Executive Officer, Chief Operating Officer
      and Chief Financial Officer do not change both immediately after the
      Change in Control and for at least 180 days thereafter except as a result
      of their death or Disability and (ii) none of such officers shall have
      changed prior to the Change in Control at the direction of a Person who
      has entered into an agreement with the Company the consummation of which
      will constitute a Change in Control or who has caused a Potential Change
      in Control to occur; or (B) the transactions contemplated by the Merger
      Agreement.

      14.5 "CODE" shall mean the Internal Revenue Code of 1986, as amended from
time to time.

      14.6 "COMPANY" shall mean Vanguard Health Systems, Inc. and any successor
to its business and/or assets which assumes and agrees to perform this Agreement
by operation of law, or otherwise including, without limitation, any Person
required to assume this Agreement as the Successor pursuant to Section 9.1
(except in determining, under Section 14.4 hereof, whether or not any Change in
Control of the Company has occurred in connection with such succession).

      14.7 "DATE OF TERMINATION" shall have the meaning stated in Section 7.2
hereof.

      14.8 "DISABILITY" shall be deemed the reason for the termination by the
Company of the Executive's employment, if, as a result of the Executive's
incapacity due to physical or mental illness, the Executive shall have been
absent from the full-time performance of the Executive's duties with the Company
for a period of six (6) consecutive months, the Company shall have given the
Executive a Notice of Termination for Disability, and, within thirty (30) days
after such Notice of Termination is given, the Executive shall not have returned
to the full-time performance of the Executive's duties.

                                      -11-
<PAGE>

      14.9 "EXCHANGE ACT" shall mean the Securities Exchange Act of 1934, as
amended from time to time.

      14.10 "EXECUTIVE" shall mean the individual named in the first paragraph
of this Agreement.

      14.11 "GOOD REASON" for termination by the Executive of the Executive's
employment shall mean the occurrence (without the Executive's express written
consent) of any one of the following acts by the Company, or failures by the
Company to act, unless, in the case of any act or failure to act described
below, such act or failure to act is corrected prior to the Date of Termination
specified in the Notice of Termination given in respect thereof:

            (a) any change in the Executive's title, authorities,
      responsibilities (including reporting responsibilities) which, in the
      Executive's reasonable judgment, represents an adverse change from his
      status, title, position or responsibilities (including reporting
      responsibilities) which were in effect immediately prior to the Change in
      Control or from his status, title, position, or responsibilities
      (including reporting responsibilities) which were in effect following a
      Change in Control pursuant to the Executive's consent to accept any such
      change; the assignment to him of any duties or work responsibilities
      which, in his reasonable judgment, are inconsistent with such status,
      title, position or work responsibilities; or any removal of the Executive
      from, or failure to reappoint or reelect him to any of such positions,
      except if any such changes are because of Disability, Retirement, death or
      Cause;

            (b) a reduction by the Company in the Executive's annual base salary
      as in effect on the date hereof or as the same may be increased from time
      to time except for across-the-board salary reductions similarly affecting
      all senior executives of the Company and all senior executives of any
      Person in control of the Company;

            (c) the relocation of the Executive's office at which he is to
      perform his duties, to a location more than thirty (30) miles from the
      location at which the Executive performed his duties prior to the Change
      in Control, except for required travel on the Company's business to an
      extent substantially consistent with his business travel obligations prior
      to the Change in Control;

            (d) if the Executive had been based at the Company's principal
      executive offices immediately prior to the Change in Control, the
      relocation of the Company's principal executive offices to a location more
      than 30 miles from the location of such offices immediately prior to the
      Change in Control;

            (e) the failure by the Company, without the Executive's consent, to
      pay to the Executive any portion of the Executive's current compensation,
      or to

                                      -12-
<PAGE>

      pay to the Executive any portion of an installment of deferred
      compensation under any deferred compensation program of the Company,
      within seven (7) days of the date such compensation is due;

            (f) the failure by the Company to continue in effect any stock-based
      and/or cash annual or long-term incentive compensation plan in which the
      Executive participates immediately prior to the Change in Control, unless
      the Executive participates after the Change in Control in other comparable
      plans generally available to senior executives of the Company and senior
      executives of any Person in control of the Company;

            (g) the failure by the Company to continue to provide the Executive
      with benefits substantially similar in value to the Executive in the
      aggregate to those enjoyed by the Executive under any of the Company's
      pension, life insurance, medical, health and accident, or disability plans
      in which the Executive was participating immediately prior to the Change
      in Control, unless the Executive participates after the Change in Control
      in other comparable benefit plans generally available to senior executives
      of the Company and senior executives of any Person in control of the
      Company;

            (h) the adverse and substantial alteration of the nature and quality
      of the office space within which the Executive performed his duties prior
      to a Change in Control as well as in the secretarial and administrative
      support provided to the Executive; provided, however, that a reasonable
      alteration of the secretarial or administrative support provided to the
      Executive as a result of reasonable measures implemented by the Company to
      effectuate a cost-reduction or consolidation program shall not constitute
      Good Reason hereunder;

            (i) any material breach by the Company of any provision of this
      Agreement; or

            (j) any purported termination of the Executive's employment which is
      not effected pursuant to a Notice of Termination satisfying the
      requirements of Section 7.1; for purposes of this Agreement, no such
      purported termination shall be effective.

The Executive's right to terminate the Executive's employment for Good Reason
shall not be affected by the Executive's incapacity due to physical or mental
illness, unless Executive shall have incurred a Disability; provided, that the
temporary assignment of the Executive's responsibilities to another employee of
the Company during the period of the Executive's incapacity shall not itself
constitute Good Reason. The Executive's continued employment shall not
constitute consent to, or a waiver of rights with respect to, any act or failure
to act constituting Good Reason hereunder.

                                      -13-
<PAGE>

      14.12 "NOTICE OF TERMINATION" shall have the meaning stated in Section 7.1
hereof.

      14.13 "PERSON" shall have the meaning given in Section 3(a)(9) of the
Exchange Act, as modified and used in Section 13(d) and 14(d) thereof; however,
a Person shall not include (i) the Company or any of its subsidiaries, (ii) any
trustee or other fiduciary holding securities under an employee benefit plan of
the Company or any of its subsidiaries, (iii) an underwriter temporarily holding
securities pursuant to an offering of such securities, (iv) any entity owned,
directly or indirectly, by the stockholders of the Company in substantially the
same proportions as their ownership of the Company's common stock, (v) any
person or entity that is a stockholder of the Company as of the date hereof and
any affiliates of such person or entity, or (vi) Blackstone (as defined in the
Company's 2004 Stock Incentive Plan) or its affiliates.

      14.14 "POTENTIAL CHANGE IN CONTROL" shall be deemed to have occurred if
the conditions set forth in any one of the following paragraphs shall have been
satisfied:

            (a) the Company enters into an agreement, the consummation of which
      would result in the occurrence of a Change in Control;

            (b) the Company or any Person publicly announces an intention to
      take or to consider taking actions which, if consummated, would constitute
      a Change in Control;

            (c) any Person who is or becomes the Beneficial Owner, directly or
      indirectly, of securities of the Company representing 10% or more of the
      combined voting power of the Company's then outstanding securities
      increases such Person's beneficial ownership of such securities by 5% or
      more of the combined voting power of the Company's then outstanding
      securities (not including in the securities beneficially owned by such
      Person any securities acquired directly from the Company); or

            (d) the Board adopts a resolution to the effect that, for purposes
      of this Agreement, a Potential Change in Control has occurred.

      14.15 "RETIREMENT" shall be deemed the reason for the termination by the
Company or the Executive of the Executive's employment if such employment is
terminated in accordance with the Company's retirement policy or qualified
retirement plan, not including early retirement, generally applicable to its
salaried employees, as in effect immediately prior to the Change in Control, or
in accordance with any retirement arrangement established with the Executive's
consent with respect to the Executive.

      14.16 "SEVERANCE PAYMENTS" shall mean those payments described in Section
6.1 hereof.

                                      -14-
<PAGE>

      14.17 "SUCCESSOR" is defined in Section 9.1.

      14.18 "TOTAL PAYMENTS" shall mean those payments described in Section 6.2
hereof.

      14.19 "WAIVER" is defined in Section 11.

               [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK.]

                                      -15-
<PAGE>

      IN WITNESS WHEREOF, the Company has caused this Agreement to be executed
by its duly authorized officer and the Executive has executed this Agreement,
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
                                              ----------------------------------
                                              Name: Kent H. Wallace

               [Signature Page to Severance Protection Agreement]

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