In this paper we study the problem of personnel planning in care-at-home facilities. We model the system as a Markov decision process, which leads to a high-dimensional control problem. We study monotonicity properties of the system and derive structural results for the optimal policy. Based on these insights, we propose a trunk reservation heuristic to control the system. We provide numerical evidence that the heuristic yields close to optimal performance, and scales well for large problem instances. © 2011 Elsevier B.V. All rights reserved.