A private-pay home care agency has never billed Medicare in its life. Its website has a helpful article for families, "How to Pay for Home Care," that explains what Medicare does and doesn't cover. Then Google's AI reads the article and writes a new headline for the agency's ad: "Medicare-Covered Care at Home."
Nobody at the agency wrote that line. Nobody approved it. And a family who calls because of it is going to be angry by the end of the first phone call.
That's the risk this chapter is about. AI Max is Google's newest layer of automation in Search campaigns, and one of its features writes ad text from your website. In most businesses a clumsy AI headline is embarrassing. In home care it can promise a payer you don't accept, quote a price from a 2016 article, or turn a job posting into a client ad. This chapter explains what AI Max is, when our method switches it on, and the fences that go up first.
AI Max Lives Inside Your Search Campaign, and Google Switched Many Accounts On in September
Nothing new appears in the campaign list when AI Max is on. It's three settings tucked into the Search campaign a home care agency already runs:
- Search term matching lets Google decide your ad fits searches you never added, much as broad match would.
- Text customization has Google draft extra headlines and descriptions in your name.
- Final URL expansion lets Google swap the landing page for whichever page on your site it prefers.
Build a new Search campaign today and those settings arrive already on. Older campaigns weren't spared either. If an agency's campaign let Google write extra ad lines, or used the old account-wide broad setting, Google upgraded it to AI Max at some point in September 2026, and no one had to click yes. Many agencies built those campaigns years ago and haven't opened the settings since. That makes a five-minute check worth doing this week. Our post on the September AI Max switch walks through how to tell whether yours was one of them. If your agency ran Search campaigns before September, check them now.
Google also says the three features need conversion-based Smart Bidding to work well. That's a clue to where AI Max belongs in the order of things, which we come back to below.
Text Customization Writes From Every Page on Your Domain, Including the Medicare Article and the Pay Rates
The source material for text customization is broad. Google's setup page lists your domain first, ahead of landing pages, existing ads and keywords. For an agency, the domain means every page on the site: the service pages, and also the blog, the FAQ, the careers section and the paying-for-care guides.
Home care websites carry a lot of text that should never appear in a client ad. We found three kinds on agency sites in our example market, Chicago:
- Coverage explanations. Custom Home Care, a non-medical agency that isn't Medicare-certified, publishes a helpful article explaining that Medicare "may cover limited home health care, not ongoing custodial home care." Every word of that is accurate. Cut to a 30-character headline, "Medicare" and "home care" are the words most likely to survive.
- Old price figures. Assisting Hands' How to Pay page cites a national average: "Nationwide in 2016, the average cost for non-medical home care is $20 per hour." That's useful context on a page. As an ad line it's a price the agency doesn't charge.
- Job pay. Home Care Powered by AUAF titles its careers page "$21/hr In-Home Caregiver Career." That's a strong recruiting line, on the same domain as every client page.
We haven't seen these agencies' ads contain any of these lines, and we're not saying AI Max wrote them. Our point is narrower: text customization is allowed to read these pages, and nothing in the default settings stops it from using them. Chapter 8 showed that a Medicare coverage claim needs its conditions stated, and that some states regulate home care advertising closely. A generated headline doesn't include conditions.
AI Max Comes Last in Our Method, Never in an Exact-Match Account
Our method treats AI Max as broad match with extra features, because search term matching is exactly that: Google choosing which searches your ad shows for. So it follows the same rule Chapter 6 set for broad match, and then waits a little longer.
The order runs like this. Isolation first: exact match, manual bids, only the searches you know bring clients. Then Exploration, once the account brings in about 30 client leads a month: broad match with target cost per lead. Then Performance Max and Demand Gen. AI Max comes last, after all of those have proven what a client lead looks like in your account.
That order matters more in home care than in most industries. An account with a few client leads a month and a steady stream of job applicants gives Google very little to learn from and a lot to get wrong. Until the account has reliable client conversions, turn AI Max off when you build each campaign, as Chapter 9 laid out, and check that it stays off.
Twenty-Five Banned Words and Forty Written Rules Fence In What AI Max Writes
When the account is ready, the first fence is text guidelines, a Google feature still in beta that controls what AI Max is allowed to write. It has two parts.
Term exclusions are words that can never appear in generated text. Google allows up to 25 per campaign. For a home care agency, the list usually starts with:
- "Medicare" and "Medicaid," if you don't accept them
- "free," "guarantee" and "guaranteed"
- "nurse" and "nursing," for a non-medical agency
- "hiring," "jobs," "pay" and "apply"
- "24/7" and "same-day," unless you can deliver them every time
Messaging restrictions are rules written in plain sentences. Google allows up to 40 per campaign, and they catch what single words can't. One matters more than the rest: prices. Google notes that a "{{BODY}}quot; term exclusion won't stop generated prices and recommends a messaging restriction instead: "Don't generate assets with prices." Add rules such as:
- "Don't mention insurance, Medicare or Medicaid coverage."
- "Don't mention jobs, wages or hiring."
- "Don't promise a start time, such as same day or within 24 hours."
- "Don't describe our caregivers as nurses."
Google's advice is to give an example inside a restriction when you can, for instance "Don't mention insurance coverage, e.g. 'Medicare covers home care.'" Guidelines also work backward: when you add them, Google removes any generated text already running that breaks them.
URL Exclusions Keep AI Max Off the Careers Page and the Paying-for-Care Articles
The second fence is about pages. Final URL expansion can send a family to any page on your site, which in home care includes careers pages, job applications and articles about paying for care. It's the same problem Chapter 10 solved for Performance Max, and the tools are similar.
- URL exclusions stop AI Max from sending traffic to the pages you list: careers, jobs, apply, and resource articles that explain Medicare or quote national prices. Your own how-to-pay page can stay a sitelink you wrote (Chapter 8); it just shouldn't be a page AI Max picks on its own.
- URL inclusions do the opposite and limit the campaign to the pages you choose. For most agencies, the tighter choice is better: include only the service pages Chapter 4 built, such as companion care, dementia care, 24-hour care and home health.
Two details matter. URL exclusions only work with text customization and Final URL expansion both on. And switching text customization off switches Final URL expansion off with it, which is one more reason to decide these settings together rather than one at a time.
Brand controls sit in the same part of the settings. Brand exclusions keep AI Max away from searches for your own agency's name, which your branded campaign already covers (Chapter 9).
Run AI Max as an Experiment and Read Every Line It Writes
Even with both fences up, don't switch AI Max on across the account. AI Max comes with its own test mode. Half the campaign's traffic keeps today's settings and half gets AI Max, and after a few weeks the agency can put the two sets of client leads next to each other.
Run it on one campaign, ideally your strongest private-pay service, for at least a few weeks. Then check three reports every week while it runs:
- The search terms. AI Max will show your ads for searches you never chose. Job searches, nursing home searches and Medicare questions go straight onto the negative list from Chapter 5.
- The generated text. Read every headline and description AI Max has written. Remove any line that promises coverage, quotes a price, mentions a job, or says something your agency can't deliver.
- The landing pages. Confirm that every click went to a service page, not a careers page or an article.
Keep a simple log while it runs: the date, the line or search you removed, and why. After a month the log shows whether AI Max is learning your agency or repeating the same mistakes, and it gives the next person who manages the account a record of what was already tried.
Judge the experiment by client leads, as Chapter 1 defines them, not by clicks or conversions in general. AI Max can raise click volume easily. The question is whether it brings more families who hire you, at a cost Chapter 3 says you can afford.
Next: Recruiting Caregivers Costs Less Than Finding Clients, but Job Ads Can't Target Age or ZIP
Every chapter so far has kept job seekers out of client campaigns. Chapter 14 turns around and goes after them on purpose, with a recruiting campaign of its own, cheaper clicks, and Google's employment rules that ban age and ZIP code targeting on job ads.
If you're starting here, Chapter 6 covers broad match and the 30-lead threshold, Chapter 8 covers which ad claims come with rules, and Chapter 10 sets up the careers-page exclusions. The guide home lists all fifteen chapters.
Under our Google Ads management, AI Max stays off in a home care account until the text guidelines and URL exclusions are written and reviewed.
