A home care agency turns on Performance Max, and within two weeks the lead count doubles. The owner is thrilled until the office manager starts returning the calls. Half the new "leads" are caregivers asking about the job posted on the website, the one with the "Now Hiring, $21 an Hour" banner. The campaign did exactly what it was told. It found people who filled out a form on the site, and job applicants are the easiest people in home care to find.
Performance Max can be a strong campaign for an agency once the account is ready for it. It can also turn a client budget into a recruiting budget without anyone deciding to. This chapter shows why home care is especially exposed, and the four settings that keep the campaign aimed at families.
Performance Max Runs Your Ads Everywhere Google Sells Space, and It Picks the Landing Page Too
A Search campaign shows text ads on Google search results, and you choose every keyword and every landing page. Performance Max is one campaign with one budget that runs across Search, YouTube, Display, Discover, Gmail and Maps. You give it headlines, images, videos and a goal, and Google decides where each ad appears, who sees it and, unless you stop it, which page of your site it sends them to.
That last part is called Final URL expansion, and Google switches it on by default. Google's own help page puts it plainly: the campaign "can serve and receive traffic on any page that hasn't been excluded." The landing page you picked becomes a suggestion. Google can swap in any other page it thinks will convert better.
That's why our method doesn't start Performance Max early. It comes after Search has run for about six months with clean conversion tracking, so the campaign learns from real client leads rather than guessing. By then you know which searches bring clients, which ad lines work and what a lead is worth (Chapter 3). Performance Max is a way to reach more of those families, not a way to find out who they are.
11 of 12 Agency Sites in Our Example Market Link Their Careers Page From the Top Menu
Home care agencies hire constantly, so their websites work as recruiting sites too. We reviewed the websites of 12 home care and home health agencies advertising in our example market, Chicago. Eleven put a careers link in the header or top menu. Only CenterWell Home Health kept it in the footer.
Several went further. BrightStar Care puts a "Careers" button right next to its contact button at the top of its Chicago office homepage. Help at Home runs two header buttons, "View All Jobs" and "Become a Caregiver Today." Tribute Home Care offers three equal buttons on its homepage: "Home Care Services," "Caregiver Careers" and "Care Professionals." And as Chapter 1 showed, many agencies put the job application in the same contact form as the care request.
That's good recruiting. It's also a map for Final URL expansion. Four of the twelve agencies run their job listings on a separate careers website. The rest keep their careers pages on the same site as their client pages. To a campaign allowed to send traffic to "any page that hasn't been excluded," a page titled "$21 an Hour Caregiver Career" is just another page with a form on it.
One in Six Searches in Our Keyword List Is a Caregiver Job Hunt, and Those Clicks Cost Far Less
The searches point the same way. In the 24,442 searches we pulled from Keyword Planner for our example market (Chapter 5), 3,883 were caregiver, aide or nursing job searches, about one in six. "cna jobs near me" alone draws 6,600 searches a month in the metro area.
Those clicks are cheap. To reach the top of the page in our example market, Keyword Planner puts a job seeker's click on "caregiver jobs near me" at 60 cents to $2.99. A family's click on "home care services" costs $3.48 to $12.78, several times as much.
Put those facts together. A campaign told to get the most conversions for its budget, able to send traffic to any page, will find the cheap conversions first if an application counts as one. That's our reading of how the pieces fit, not something Google states, but it is the pattern the opening story describes, and it's why Chapter 1 made the care request the only lead that counts.
Four Locks Keep Performance Max Pointed at Families
None of this means an agency should avoid Performance Max. It means the campaign needs four locks before it launches.
Lock 1: the goal counts care requests only. Set the campaign's conversion goal to the actions Chapter 1 built: the care request form, calls long enough to be real inquiries, and consultations booked. The job application stays out of the goal. This is the lock that matters most, because it decides what the campaign is trying to find.
Lock 2: URL exclusions for every careers page. Leave Final URL expansion on only if you add exclusion rules, using "URL contains" rules for the words your careers pages use: careers, jobs, apply, employment, join-our-team, hiring. Check your site's menu for others. The other choice is to untick Final URL expansion entirely, and then every ad lands only on the pages named in your asset groups. For an agency whose site mixes jobs and care on every page, that's the safer start.
Lock 3: negative keywords from Chapter 5. Performance Max now accepts negative keywords, either on the campaign or through a shared negative keyword list, so the job-search list from Chapter 5 can go straight in. Know the limit: Google says Performance Max negatives cover "Search and Shopping inventory only." They won't stop a YouTube or Display ad from reaching a job seeker, which is why the first two locks come first.
Lock 4: brand exclusions. Exclude your agency's own name, so Performance Max doesn't spend on families who already searched for you and would have called anyway. Your branded Search campaign covers them, at a lower cost and with a report you can read (Chapter 9).
Health Rules Limit the Audiences You Can Hand Performance Max
Performance Max asks for audience signals, lists of people you think are likely to convert. They're optional, and Google is open about treating them as a starting point: when it sees a likely conversion elsewhere, it will go there. A signal points the campaign at the adult child reading about dementia care. It doesn't keep the campaign away from the caregiver reading job boards.
Home care has a second limit. Google's policy on health in personalized advertising covers physical and mental health conditions and, in its own words, "disabilities, even when content is oriented toward the user's primary caretaker." That caretaker line reaches the adult child arranging care for a parent. Under the policy, ads in these categories can't use remarketing lists, Customer Match or lookalike audiences. Our reading is that dementia care and home health ads fall inside it. Companion care ads that name no condition may not, so check your ads' status in the account before you count on any audience.
Expect some of your ads to show "Eligible (limited)" in the account once they're reviewed. That status means the ad runs, with fewer audience options, and it's the clearest sign of which of your ads Google reads as health ads.
What's left is still useful. Google's own in-market and life-event audiences remain available, and so do custom segments you build from two sources:
- The searches families make: "in home care for elderly parent," "24 hour home care," "dementia care at home." Use the client searches from Chapter 5, never the job searches.
- The websites families visit before they call: the franchise brands and referral sites bidding in your market (Chapter 7 names them). A custom segment built from those websites describes the kind of person reading them. It doesn't show ads to their customers by name.
Give Performance Max Your Best Search Headlines and Real Photos of Your Caregivers
Performance Max builds its ads from the pieces you give it, so give it pieces that already work. Keep the same split your Search account has: one asset group for home care and one for home health, each with its own final URL, headlines and images. A family looking for help with bathing and a patient coming home after surgery shouldn't see the same ad or land on the same page (Chapter 4).
- Headlines and descriptions: move in the Search lines with six months of results behind them, the family-review headlines from Chapter 8 first. Skip the AI-written suggestions Google offers during setup; they tend toward the "compassionate, quality care" language every agency already uses.
- Images: real photos of your caregivers and office staff, with their written permission, not stock photos of smiling seniors. Families can tell, and a caregiver they may actually meet builds more trust than a model.
- Video: leave the video slot empty and Google fills it by stitching your photos and headlines into a slideshow. A 30-second phone video of your care manager explaining how the first visit works will do better than anything assembled automatically.
- Bidding: launch on the conversions goal without a target cost per lead, and add a target once the campaign has a few weeks of client leads to learn from.
Then read the reports every week for the first month. Performance Max shows which search categories and landing pages got traffic. If a careers URL or a job search slips through, that's a lock that needs tightening, and it needs it that week, not at the end of the quarter.
Next: Demand Gen Can Reach the Adult Child Before the Fall
Performance Max works best on families who are already looking. Many adult children aren't looking yet: they've noticed Dad skipping meals or Mom missing appointments, and they haven't typed anything into Google. Chapter 11 covers Demand Gen, the campaign that reaches them on YouTube and Gmail before the fall that sends them searching. Chapter 14 comes back to recruiting and gives job ads a campaign of their own.
If you're starting here, Chapter 1 builds the care-request conversion that Performance Max needs, Chapter 5 builds the job-search negative list, and Chapter 9 covers the launch settings. The guide home lists all fifteen chapters.
Under our Google Ads management, a home care Performance Max campaign doesn't launch until all four locks are on.
