Vanguard Health Systems, Nashville, has made further inroads into Connecticut, signing a second deal in the state with a letter of intent to acquire Bristol (Conn.) Hospital and Health Care Group.

The for-profit system this month signed a deal to form a joint venture that would operate Waterbury (Conn.) Hospital.

Financial terms for the Bristol deal were not disclosed. In a news release, Marie O'Brien, chairman of the Bristol Hospital board of directors, said the deal would allow the medical center to complete extensive renovations to its main campus and expand its outpatient services.

She also noted that the transaction would help with recruiting and retaining physicians.

A definitive purchase agreement is being prepared over the next 60 days, according to the release. The takeover requires approval from the state's Office of Health Care Access and the Office of the Attorney General.

The deal also calls for a 10-member board of trustees to be created with four physicians, five community leaders and Bristol's current president and CEO, Kurt Barwis.

The transaction follows a deal that Bristol recently signed to become a member of the Yale-New Haven Health System. That arrangement allows the medical centers to coordinate joint clinical programs as well as form purchasing agreements and protocols for transferring patients to Yale for tertiary care.