Vanguard Health Systems (VHS) 8-K Results of Operations and Financial Condition

EXHIBIT 99.3

VANGUARD HEALTH SYSTEMS, INC.
Calculation of Certain Financial Covenants under Senior Secured Credit Agreement
June 30, 2009

($ presented in millions)				Trailing twelve months ended June 30, 2009
Interest Coverage Ratio
Adjusted EBITDA(1)	$			302.4
Add:  Equity method cash distributions received				1.1
Less:  Minority interest distributions paid				(4.9	)
Add:  Franchise tax expense				0.2
Add:  Gross interest income recognized				2.4
Add:  Capitalized interest recorded				2.0
Consolidated EBITDA, as defined in senior secured credit agreement		$		303.2		A
Net interest	$			111.6
Add:  Capitalized interest recorded				2.0
Less:  Non-cash accretion of senior discount notes				(21.8	)
Less:  Non-cash amortization of financing costs				(5.4	)
Less:  Interest related to specified construction projects				(1.3	)
Consolidated cash interest expense, as defined in senior secured credit agreement		$		85.1		B
Interest coverage ratio (A/B)				3.56x
Minimum interest coverage ratio required as of June 30, 2009				2.00x
				As of June 30, 2009
Leverage Ratio
Borrowings outstanding under senior term credit facility	$			766.4
9.0% senior subordinated notes outstanding				575.0
Less:  Cash and cash equivalents				(308.2	)
Less:  Restricted cash				(1.9	)
Less:  Debt incurred to fund specified construction projects				(16.3	)
Consolidated debt, as defined in senior secured credit agreement			$	1,015.0		C
Consolidated EBITDA, as defined in senior secured credit agreement			$	303.2		A
Leverage ratio (C/A)				3.35x
Maximum leverage ratio allowed as of June 30, 2009				4.50x

VANGUARD HEALTH SYSTEMS, INC.
Calculation of Certain Financial Covenants under Senior Secured Credit Agreement
June 30, 2009
(continued)

($ presented in millions)		Trailing twelve months ended June 30, 2009
Senior Leverage Ratio
Consolidated debt, as defined in senior secured credit agreement	$	1,015.0
Less:  9.0% senior subordinated notes outstanding		(575.0	)
Consolidated senior debt, as defined in senior secured credit agreement	$	440.0		D
Consolidated EBITDA, as defined in senior secured credit agreement	$	303.2		A
Senior leverage ratio (D/A)		1.45x
Maximum senior leverage ratio allowed as of June 30, 2009		3.50x

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⁽¹⁾Adjusted EBITDA is defined as income before interest expense (net of interest income), income taxes, depreciation and amortization, minority interests, gain or loss on disposal of assets, equity method income, stock compensation, monitoring fees and expenses, realized holding loss on investments, impairment loss and discontinued operations, net of taxes. Adjusted EBITDA is not intended as a substitute for net income, operating cash flows or other cash flow statement data determined in accordance with accounting principles generally accepted in the United States. Due to varying methods of calculation, Adjusted EBITDA as presented may not be comparable to similarly titled measures of other companies. The following table provides a reconciliation of Adjusted EBITDA to net income during the trailing twelve months ended June 30, 2009 (in millions).

		Trailing twelve months ended June 30, 2009
Net income	$	28.6
Interest, net		111.6
Income tax expense		16.0
Depreciation and amortization		130.6
Minority interests		3.2
Gain on disposal of assets		(2.3	)
Equity method income		(0.8	)
Stock compensation		4.4
Monitoring fees and expenses		5.2
Realized holding loss on investments		0.6
Impairment loss		6.2
Discontinued operations, net of taxes		(0.9	)
Adjusted EBITDA	$	302.4