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Abstract — A method for detecting falls in the homes of older adults using the Microsoft Kinect and a two-stage fall detection system is presented. The first stage of the detection system characterizes a person’s vertical state in individual depth image frames, and then segments on ground events from the vertical state time series obtained by tracking the person over time. The second stage uses an ensemble of decision trees to compute a confidence that a fall preceded an on ground event. Evaluation was conducted in the actual homes of older adults, using a combined nine years of continuous data collected in 13 apartments. The data set includes 454 falls, 445 falls performed by trained stunt actors and 9 naturally occurring resident falls. The extensive data collection allows for characterization of system performance under real-world conditions to a degree that has not been shown in other studies. Cross validation results are included for standing, sitting, and lying down positions, near (within 4 m) vs. far fall locations, and occluded vs. not occluded fallers. The method is compared against five state-of-the-art fall detection algorithms and significantly better results are achieved. Index Terms—fall detection, Kinect, older adults I