The airplane was destroyed when it impacted terrain while flying the VOR/GPS Runway 22 approach at approximately 2145 Mountain time. Night instrument conditions prevailed for the air ambulance repositioning flight. The ATP-rated pilot and two crew members sustained fatal injuries; one crew member sustained serious injuries. The cross-country flight originated at Steamboat Springs, Colorado, at approximately 2115 to pick up a patient. According to the Denver Air Route Traffic Control Center, the airplane was lost from radar at 9200 feet msl in the middle of the procedure turn for the instrument approach to Runway 22 at 2142.