His first scene has him coming out of a mirror with an unholy screech, reaching into a man's chest, and squeezing the life out of his heart, killing him.
The finale in which Frank and Lucy have to evade Patricia, who's armed with a shotgun as Frank constantly shifts between the present and the past hospital, bearing witness to the horrible massacre that happened many years ago, often from the perspective of the people being slaughtered.
"I'm in the mood for vivisection!" "Me too! Me too!" (they're referring to vivisection with a pick ax!)
The implications of a spirit missing both chances to move on. You are stuck in this plane of existence until you just fall apart. The Judge has been around for quite a while, and showed no signs he was about to give up the ghost anytime soon. And if no one around has had near-death trauma, then the only people who can hear you are other ghosts, who are equally stranded.
Since Bartlett is able to follow Frank and Patricia when they go through the tunnel, it seems that you can hitch a ride on another spirit's ascension. Which may explain why places like hospitals often seem haunted. It's like a bus station for ghosts; they're just waiting around for the next ride out of town.
An example from the Director's Cut that crosses over with Squick. Frank experiences a scene where Johnny and Patricia are playing around in the morgue, and start making love on an examination table, Patricia's foot dipping into a scale filled with some corpse's innards. Gross.