S+ Tier

SkinwalkerFront DeskDisguised patient with a measurable discrepancy between the Monitor Camera and the Photo Camera. Counter with the Taser or intentionally wrong medicine (0% rating penalty).

S Tier

Mass of EyesArea DenialDrains 10-15% Sanity per second on direct visual contact. Mandatory counter: 1x Eye Drops while looking up. Failing to clear it shuts down 50% of corridor routing.

A Tier

Bed MonsterProximityAggro radius is approximately a 4x4 stud box around the affected bed. Counter: stand inside the hitbox while holding 1x Maple Syrup; the entity consumes it and despawns.Camouflage Entity (Wall Monster)PursuitBlends into the wall geometry. A whispered 'Run' audio cue flags proximity. Counter: 1x Fire Extinguisher aimed at the wall — forces a despawn.Crazed PatientDeath RitualExhibits twitching and hollow eyes. Initiates a Death Ritual with radial candle spawns. Counter: 1x IV Drops on the candles, or Taser on the NPC.Tentacle HazardSpatialSpawns exclusively in Room 8 during patient healing. The player has a strict 45-second window to remain near the patient. Failure results in patient abduction and rating penalty.

B Tier

Window BangerPsychological StressorBangs on the office window. Engaging dialogue to 'tell it to leave' inflicts a flat -20% Sanity. Counter: sprint past and lock an interior door, or pacify with 3-sip coffee exchange (2 sips consumed, 1 given).Cursed PhotographStaticA photograph that drains -20% Sanity on direct inspection. Avoid looking directly; use peripheral vision to gather context.Black FigureSight DrainBlack humanoid silhouette. Continuous sanity drain on line-of-sight. Taser on direct confirmation; otherwise retreat.