Various embodiments concern video patient monitoring with detection zones. Various embodiments can comprise a camera, a user interface, and a computing system. The computing system can be configured to perform various steps based on reception of a frame from the camera, including: calculate a background luminance of the frame； monitor for a luminance change of a zone as compared to one or more previous frames, the luminance change indicative of patient motion in the zone； and compare the background luminance to an aggregate background luminance, the aggregate background luminance based on the plurality of frames. If the background luminance changed by more than a predetermined amount, then the aggregate background luminance can be set to the background luminance, luminance information of the previous frames can be disregarded, and motion detection can be disregarded.
