The brothers appear and chase the girls through the building, forcing them to exit through a window but Jenna is killed before she can escape. When Kyle falls asleep, the brothers escape their cell and the girls accidentally stab Kyle to death after mistaking him as one of the Hillickers. The rest of the group chases the cannibals and locks them in a cell as Kyle stays behind to watch the brothers while the others search for the spark-plug wires. Kyle, Daniel, and Sara go into the basement to get weapons, but Daniel gets abducted, tied to a table in the kitchen, and slowly butchered and eaten alive. Lauren skies down the mountain to seek help while the others barricade themselves in the doctor's office.
The group attempts to flee the building but the spark plug wires from their snowmobiles have been taken out. After Porter's severed head is thrown at the group, Claire is hanged from a balcony with barbed wire by the trio and decapitated. Jenna comes across the Hillickers butchering Porter's body in the kitchen and runs back to warn the others. The next day, with the storm still in full effect, the teens remain trapped. As the group goes to bed, Vincent continues to explore the asylum where he finds Porter's corpse before Saw Tooth kills him with a metal spike. Lauren remembers her brother's stories about the sanatorium and the cannibals, but her friends don't believe her.
However, they get lost in a snowstorm and are forced to take shelter in the Glensville Sanatorium for the night, where the Hillickers are living. Twenty-nine years later, in 2003, nine Weston University students – Kenia, Jenna, Vincent, Sara, Bridget, Kyle, Claire, Daniel, and Lauren – spend their winter break snowmobiling on the way to their friend Porter's cabin in the mountains. Together, they cause a riot and brutally massacre the orderlies and doctors. In 1974, at the Glenville Sanatorium in West Virginia, Three Finger, Saw Tooth, and One Eye known as the Hillicker Brothers, escape from their cells and release the other patients.
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