AMENDMENT NO. 4 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT

EXHIBIT 10.63

AMENDMENT NO. 4
TO
AMENDED AND RESTATED EMPLOYMENT AGREEMENT

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

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

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

            NOW, THEREFORE , in consideration of the premises and the mutual covenants herein contained, the Company and