According to a report from a nonprofit group, Vanguard's Detroit Medical Center failed to deliver on capital projects commitments made at the time of that facility's sale to the Nashville company. To blame: too little space.

But the DMC fell short of its obligation to spend $80 million each year in capital projects for the next five years, primarily because there was lack of physical space on the downtown medical campus to start construction projects, said the report, prepared by Legacy DMC President Joe Walsh.

The DMC spent $38.2 million on specified capital projects in 2011, forcing Vanguard to place $41.8 million in an escrow account in February.