|At the Pierpont Inn, the owner Susan Thompson is closing it and preparing to move. Her two daughters, Tyler and Maggie, complain about the move. Tyler goes up to put her dolls away but notices that one has had its head twisted around. She hears a scream and goes to see that the mover has fallen down the stairs… his head twisted around and an antique doll lying next to him.
In Peoria, IL, Sam is trying to track down the missing Ava with Ellen’s help. She hasn’t had much luck but reports two mysterious deaths at a hotel. Sam wants to investigate to save who they can and go to the hotel. As they go in, Sam notices a hoodoo mark on an urn. They get a room then go to check things, while noticing more hoodoo marks. They talk to Susan and notice she has a number of antique dolls. She also has a dollhouse which is an identical replica of the hotel. Sam notices the doll with the twisted head and Tyler comes in and mentions their Grandma Rose. Susan refuses to let them talk to her, saying she’s ill.
While Sam and Dean split up to check out the hotel, the buyer’s agent talks to Susan and reveals that they plan on demolishing the hotel. Tyler is playing with the dolls and there’s a doll sitting in a room just like the agent is. In his room, the agent sits on his bed as the door behind him opens. Tyler turns to see the doll hanging by its neck… while the agent is hung in the same way.
Dean finds out about the death and goes back to the room where he finds Sam drunk. Sam is depressed over the fact he couldn’t save the agent or Ava and change his destiny. He asks Dean to kill him if he turns evil and says John was right to ask Dean to do it. When Sam pushes it, Dean reluctantly agrees to do it if he has to, then puts Sam to bed. He goes downstairs to the bar where he talks to the elderly bellboy, Sherwin. He talks about the hotel’s history and how it was once the Thompson family estate. Sherwin says Rose isn’t thrilled to be leaving but doesn’t want to discuss her illness. In one of the photos, Rose’s nanny Marie has a necklace with the hoodoo mark.
The next morning Sam wakes up with a massive hangover and claims he doesn’t remember Dean’s promise of the other night. After Dean briefs Sam on the situation, they go up to the attic to talk to Grandma Rose. They find her in a wheelchair, having suffered a stroke a while ago. Hoodoo requires hands-on ceremonies so they figure someone else is involved. Susan finds them intruding and demands that they leave. She then talks to Tyler, who is playing with Maggie, and when the daughter says that Maggie insists they can’t leave, Susan says Maggie is Tyler’s imaginary friend. As she leaves, Maggie says she doesn’t like Susan.
Susan is loading up the car as a swing stirs into motion nearby… as the swing on the dollhouse moves as well. Susan notices as all the playground equipment starts to move. A car comes to life on its own and tries to run Susan down, but Sam intervenes and rescues her. The brothers believe a spirit is responsible and determine Rose had her stroke just before the killing started, and she was working to suppress an evil spirit. They mention Tyler’s sister and when Susan says she doesn’t have one, they realize something’s up. Maggie is up in the attic confronting a helpless Rose when Tyler comes in. They go off to play, and Maggie assures Tyler that they will be able to play “forever.”
Susan, Dean, and Sam go upstairs where they find the antique dolls destroyed and Tyler gone. Susan reveals Rose had a sister named Margaret who drowned in a pool when she was young. Tyler and Maggie are leaning over the balcony above the pool and Maggie encourages Tyler to jump so they can be together forever. The adults are just outside but find the door locked, and Maggie throws Tyler into the pool where she starts to drown. Sam uses the urn marked with the hoodoo mark to break the supernaturally-sealed doors, while Maggie holds Tyler down. But a voice calls out Margaret’s name and she disappears, and Sam jumps into the pool and manages to get Tyler out just in time.
Upstairs, Rose confronts Maggie’s spirit and Maggie agrees to let them go if Rose does something for her. Maggie can’t understand why Rose kept her away, thinking she didn’t love her. Maggie accepts Rose’s offer and approaches her. Susan goes to get Rose and screams—Dean and Sam go up to find Rose dead.
Later Rose is taken away by the paramedics and Tyler assures them she can’t see Maggie. The brothers don’t know what happened but help Susan and Tyler leave. Sam agrees with Dean that it’s good to be back in action, but holds Dean to his promise to take care of him if he turns evil. As they leave and the police clear out the hotel, the spirits of two girls can be seen in the attic playing together: Rose and Maggie.