Floyd E. Allen General Counsel The Detroit Medical Center Corporate Administrative Offices 3990 John R — 1 Brush South Detroit, MI 48201 (313) 966-2080 (313) 966-2040 FAX

EXHIBIT 2.1

Xxxxx X. Xxxxx
General Counsel

The Detroit Medical Center
Corporate Administrative Offices
0000 Xxxx X — 0 Xxxxx Xxxxx
Xxxxxxx, XX 00000
(000) 000-0000
(000) 000-0000 FAX

July 16, 2010

Xx. Xxxxx X. Xxxxx
Executive Vice President
Vanguard Health Systems, Inc.
00 Xxxxxx Xxxxx Xxxxxxxxx, Xxxxx 000
Xxxxxxxxx, XX 00000

RE: Extension of Time under Paragraph 5.2(b), Purchase and Sale Agreement Dated June 10, 2010 (“Agreement”) by and among The Detroit Medical Center and its subsidiary organizations (“Seller”), VHS of Michigan, Inc. and its subsidiary organizations (“Buyer”) and Vanguard Health Systems, Inc.

Dear Xx. Xxxxx:

Paragraph 5.2 (b) of the Agreement permits Seller to make offers of employment to employees of Seller that are identified in writing by Seller on or before July 15, 2010. This correspondence documents our agreement to extend the time within which DMC may identify such employees until August 15, 2010.

Thank you for your consideration in this matter.

Sincerely,

Xxxxx X. Xxxxx
General Counsel

Vanguard Health Systems, Inc., on behalf
of itself and Buyer, agree to the above extension.

VANGUARD HEALTH SYSTEMS, INC.

By:		/s/ Xxxxx X. Xxxxx
		Xxxxx X. Xxxxx
Its:		Vice Chairman