Weather does not appear to be factor.

https://flightaware.com/live/flight/N558MT

ADSB data shows after crossing the highest point in the flight path a pitch up and climb along with slowing down and a tight right hand 360.  Data drops off but flight radar has more, pitches down and gains airspeed while losing altitude flowing the ridge line down for another 3 miles before landing in the first available area.  Google earth overlay shows very little to no clearance on this ridge, there is also no sign of the landing gear in any of the photos at the scene.  I hope I'm wrong but potentially clipped a ridgeline.

I am no expert, but I am pretty sure the skids are shown in the picture, broken off below the aircraft fuselage after a hard impact caused them to collapse. As for the track log seemingly going through a hilltop, when connecting the dots of track points reported by ADS-B it draws a straight line and doesn't take into account any altitude variations that occured between the two reported positions...it does not mean the aircraft hit the ridgetop with the skids or any other part of it.

Right, it doesn't mean nothing that the recorded trajectory intersects with terrain. 

There have only been pictures of the right side of the aircraft in the media so the skids tubes could very well on the other side and I'm completely wrong, I hope I am.  Only thing I see is the right rear cross tube and where the skid tube would be attached is gone.  The two holes are the mount for the long boarding step which is laying on the ground by the rear doors.  Aircraft looks like it came down vertical, didnt slide down the road so I would expect to see the skid tubes which are already outboard of the fuseluge to be spread outwards and more visible.  Of course they could have broken off more dramatically and are out of view of the camera, potentially up the embankment.  

I also agree the ADSB data isnt always perfect in terms of altitude and you have to know if you are looking at pressure alt or geo or a combination of the two, taking into account the altimeter setting in the area which on the night says the aircraft is actually higher than reported by about 190' 

Its also the amount of force it would take to crush the whole landing gear assemble and that rear crosstube to then cave in the rear of the fuseluge by the amount we see, but at the same time the impact was soft enough the forward belly area never even touched the ground and the tailboom barely flexed downwards.  Most of the time if you hit hard enough to fully spread the gear and also have the tubes riped off and under the aircraft you would expect to see further vertical impacts to the airframe and injuries.  

Just a guess here but if the skids folded, they may have been cut off by responding firefighters post-crash to extract everyone out the back end. Can't tell from the picture how clean the crosstube cut is.  

The boarding step is attached to the skids so it seems unlikely the boarding steps would ride all the way to the crash with the skids assembly gone.  

A news video from above the crash site shows what appears to be a fairly clear area on one side of the road, at this point I say props to the pilot for getting it down in relatively good shape in this sort of terrain.  

Thats a great point, looking at the photo again thinking that and there is a dent just above the fold out step in the upper left corner of where the sliding door opening is.  That dent lines up with that cross tube that is folded over and the saddle is lined up with it, like the tube was sticking straight up and hit the side of the fuselage.  Picturing the skid tube like that and where that step on the ground it makes a lot more sense.  Whatever happened crossing that high point of the ridge certainly caused controllability problems.  The open fields all around and he ended up where he was makes me think he was fighting it.  Thanksfully kept it upright and everyone walked away.  I havent seen an aerial shot yet, will look for it.

https://newschannel9.com/news/local/life-force-6-crashes-in-north-carolina-while-transporting-patient-macon-county-helicopter-erlanger-hospital-crash-accidenta>

It is HIGHLY likely that this was a CFIT accident. Aircraft was cruising at 4800' prior to the accident. A mountain in line with the flight path is 5256'. Just prior to this mountain is when the pilot like recognized the situation and did a cyclic climb, but too late. It is entirely possible to have ripped off at least the pilot side skid leaving behind the cross tubes and pilot side step. Pilot side step is visible in the post crash photos. I do not suspect hitting actual terrain, just trees. During the cyclic climb it is also possible that the fenestron and boom were damaged.

Look at the track and terrain, contour lines and everything. We will see what the pilot says in a few days.

Yep.  

Quick foreflight plot of the straight line between two hospitals shows highest enroute obstacke of 5648.  

That's more than 4800.  

Doesn't mean they were on that course but awful curious.  

pilot side skid still there

The step is there. And part of the cross tube. Don't see the skid anywhere

When did AB make this model???? 

635 is the military version of the 135

K1A5 092155Z AUTO 00000KT 10SM OVC080 13/02 A3016 RMK AO2 T01280017,M
K1A5 092215Z AUTO 07003KT 10SM OVC080 13/02 A3016 RMK AO2 T01260018,M
K1A5 092235Z AUTO 00000KT 10SM OVC070 13/02 A3016 RMK AO2 T01260022,M
K1A5 092255Z AUTO 00000KT 10SM BKN060 OVC070 12/06 A3016 RMK AO2 T01200060,M
K1A5 092315Z AUTO 05003KT 10SM SCT060 OVC080 12/04 A3016 RMK AO2 T01220041,M
K1A5 092335Z AUTO 00000KT 10SM SCT060 OVC080 13/00 A3016 RMK AO2 T01250004,M

KAVL 092254Z 18009KT 10SM OVC095 12/M02 A3012 RMK AO2 SLP197 T01221022,M
KAVL 092354Z 16007KT 10SM OVC080 12/M01 A3013 RMK AO2 SLP201 T01171011 10167 20117 55000,M K1A5 092355Z AUTO 16003KT 10SM OVC050 12/00 A3016 RMK AO2 T01241003 10179 20120,M

What A/C????? Make, Operator??????

EC135 Medtrans/GMR.  Same operating company as the PC12 that just crashed

The PC12 was a subsidiary company of GMR and not part of MTC.  

This is from Guardian's website:

Guardian Flight LLC utilizes Med-Trans Corporation, a Part 135 approved air carrier, operating under FAA certificate # M3XA227H to operate its wing aircraft. Med-Trans maintains operational control of the aircraft at all times. The following information regarding the Aviation Consumer Protection Division is provided to comply with 49 U.S.C. Section 42302. The DOT Aviation Consumer Protection Division’s contact information is as follows: Aviation Consumer Protection Division, C-75, U.S. Department of Transportation, 1200 New Jersey Avenue, SE. Washington, DC 20590 | 202.366.2220(TTY 202.336.0511) | 1.866.TELL.FAA (1.866.835.5322)

They operate two helicopers, who knew!