Vanguard Health Systems (VHS) 8-K Reconciliation of Adjusted EBITDA to Net Income (Loss) Attributable to Stockholders for Vanguard Health Systems, Inc. on a Pro Forma Basis

Exhibit 99.3

THE DETROIT MEDICAL CENTER AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEET

	September 30,
	2010
	(Unaudited)
	(In thousands)
Assets
Current assets:
Cash and cash equivalents	$	31,811
Net patient accounts receivable		181,137
Estimated third-party payor settlements		24,404
Other accounts receivable		36,677
Current portion of assets whose use is limited or restricted		3,056
Securities lending collateral		14,835
Other current assets		34,698
Total current assets		326,618
Assets whose use is limited or restricted:
Board-designated funds for capital improvements		38,119
Board-designated funds for specific purposes		62,311
Professional liability funds		166,132
Funds held in trust under bond agreements		32,419
Endowment funds		66,565
Donor restricted funds		82,028
		447,574
Property and equipment, net		442,790
Other noncurrent assets		38,007
Total assets	$	1,254,989
Liabilities and net assets
Current liabilities:
Accounts payable and accrued expenses	$	198,772
Accrued compensation and related amounts		62,613
Estimated third-party payor settlements		47,732
Payable under securities lending program		14,835
Current portion of long-term debt		24,494
Current portion of accrued professional liability losses		12,200
Total current liabilities		360,646
Other liabilities:
Long-term debt, less current portion		468,140
Accrued retirement liability		184,766
Accrued professional liability losses, less current portion		182,428
Other noncurrent liabilities		50,563
Total other liabilities		885,897
Total liabilities		1,246,543
Net assets (deficit):
Unrestricted		(140,150	)
Temporarily restricted		82,030
Permanently restricted		66,566
Total net assets		8,446
Total liabilities and net assets	$	1,254,989

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THE DETROIT MEDICAL CENTER AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS (DEFICIT)

	Three Months Ended September 30,						Nine Months Ended September 30,
	2010			2009			2010			2009
	(Unaudited)
	(In thousands)
Unrestricted revenue and other support
Net patient service revenue	$	504,812		$	502,652		$	1,502,975		$	1,476,340
Other revenue		37,437			33,666			117,231			101,227
Total unrestricted revenue and other support		542,249			536,318			1,620,206			1,577,567
Expenses
Salaries, wages, and benefits		227,130			223,975	��		671,572			660,179
Services, supplies, and other		198,622			202,832			601,593			589,099
Provision for uncollectible accounts		67,360			72,362			195,043			198,837
Professional liability insurance		319			5,548			11,924			23,688
Interest		7,242			8,137			22,141			24,252
Regulatory settlement expense		30,000			—			30,000			—
Depreciation and amortization		20,015			20,449			58,866			60,735
Total expenses		550,688			533,303			1,591,139			1,556,790
Income (loss) from operations before unrealized gains (losses) on investments		(8,439	)		3,015			29,067			20,777
Unrealized gains on investments		11,275			13,606			4,423			32,186
Income from operations		2,836			16,621			33,490			52,963
Other nonoperating income;
Investment income and other		1,997			3,426			1,720			3,045
Excess of revenue over expenses	$	4,833		$	20,047		$	35,210		$	56,008
Unrestricted net assets
Excess of revenues over expenses	$	4,833		$	20,047		$	35,210		$	56,008
Net assets released from restrictions for long-lived assets		1,558			1,155			4,172			3,418
Other changes		(1,527	)		455			(1,584	)		610
Increase in unrestricted assets		4,864			21,202			37,798			60,036
Temporarily restricted net assets
Contributions		(806	)		2,971			3,315			9,037
Investment income		803			1,634			5,461			(6,809	)
Unrealized gain in fair value of investments		9,305			8,653			3,669			21,666
Net assets released from restrictions for long-lived assets		(1,545	)		(1,155	)		(4,139	)		(3,414	)
Net assets released from restrictions for operations		(2,763	)		(2,533	)		(7,734	)		(7,542	)
Other changes		1,508			9			4,108			(1,064	)
Increase in temporarily restricted net assets		6,502			9,579			4,680			11,874
Permanently restricted net assets
Contributions		38			101			190			106
Other changes		—			(10	)		500			(10	)
Increase in permanently restricted net assets		38			91			690			96
Increase in net assets		11,404			30,872			43,168			72,006
Net deficit at beginning of period		(2,958	)		(160,742	)		(34,722	)		(201,876	)
Net assets (deficit) at end of period	$	8,446		$	(129,870	)	$	8,446		$	(129,870	)

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THE DETROIT MEDICAL CENTER AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

	Nine Months Ended September 30,
	2010			2009
	(Unaudited)
	(In thousands)
Operating activities
Increase in net assets	$	43,168		$	70,838
Adjustments to reconcile increase in net assets to cash provided by operating activities:
Depreciation and amortization		58,864			60,735
Provision for uncollectible accounts		195,043			198,837
Changes in operating assets and liabilities:
Net patient accounts receivable		(253,399	)		(232,816	)
Other current assets		10,883			15,352
Accounts payable and accrued expenses		46,369			18,715
Other current liabilities		(39,383	)		(78,891	)
Accrued retirement liability		686			23,276
Accrued professional liability losses		(394	)		(5,129	)
Other operating activities		(4,089	)		(2,224	)
Cash provided by operating activities		57,748			68,693
Investing activities
Purchase of property and equipment		(63,589	)		(50,597	)
Assets whose use is limited or restricted		(4,082	)		(25,550	)
Other investing activities		6,515			(905	)
Cash used in investing activities		(61,156	)		(77,052	)
Financing activities
Proceeds on revolving line of credit notes		—			10,278
Repayments of long-term debt		(40,077	)		(12,441	)
Cash used in financing activities		(40,077	)		(2,163	)
Decrease in cash and cash equivalents		(43,485	)		(10,522	)
Cash and cash equivalents at beginning of period		75,296			38,430
Cash and cash equivalents at end of period	$	31,811		$	27,908

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THE DETROIT MEDICAL CENTER AND SUBSIDIARIES

SUPPLEMENTAL BALANCE SHEET INFORMATION

1.   PROPERTY AND EQUIPMENT

The components of property and equipment are summarized as follows:

	September 30,
	2010
	(Unaudited)
	(In thousands)
Property and equipment:
Land & land improvements	$	14,097
Buildings & building improvements		865,410
Equipment		1,210,782
Construction in progress		22,728
Total property, plant and equipment		2,113,017
Less allowance for accumulated depreciation		(1,670,227	)
	$	442,790

2.   OTHER NONCURRENT ASSETS

The components of other noncurrent assets are summarized as follows:

	September 30,
	2010
	(Unaudited)
	(In thousands)
Other noncurrent assets:
Intangibles	$	122
Deferred debt issuance costs		8,178
Deferred compensation		1,383
Excess insurance recoverable		13,247
Other		15,077
	$	38,007

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THE DETROIT MEDICAL CENTER AND SUBSIDIARIES

SUPPLEMENTAL BALANCE SHEET INFORMATION—(Continued)

3.   LONG-TERM DEBT

The components of long-term debt are summarized as follows:

	September 30,
	2010
	(Unaudited)
	(In thousands)
Long-term debt consists of the following:
Michigan State Hospital Finance Authority (MSHFA) Bonds:
Series 1993A, interest at 6.25% to 6.5%, due 2018	$	100,280
Series 1993B, interest at 4.80% to 5.75%, due 2023		93,175
Series 1995, interest at 5.75% to 6.7%, due 2026		28,400
Series 1997A, interest at 5.0% to 5.5%, due 2027		142,690
Series 1998A, interest at 5.0% to 5.25%, due 2028		108,650
Obligations under capital leases		14,057
Notes payable and other obligations		5,382
Notes payable and other obligations		492,634
Less current portion		(24,494	)
	$	468,140

4.   OTHER NONCURRENT LIABILITIES

The components of other noncurrent liabilities are summarized as follows:

	September 30,
	2010
	(Unaudited)
	(In thousands)
Other noncurrent liabilities, less current portion:
Other postretirement liability	$	12,754
Deferred compensation liability		1,498
Due to third party payors		3,132
Minority interest in Berry Center, LLC		(48	)
Other		33,227
	$	50,563

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