For long-term care, a family finds a nursing home the way they'd find anything else: they search, they compare, they tour. For short-term rehab, the most important search happens on paper. A hospital case manager hands the family a printed list of nursing homes, and the clock starts.
No Google Ads setting puts a building on that list. What the account controls is everything that happens after the family reads it: whether your name comes up when they search it, whether someone answers when they call, and whether you can say yes before the next building does. This chapter is about those hours.
Federal Rules Make the Hospital Hand Over a List and Leave the Pick to the Family
The list isn't a courtesy. Medicare's rules for hospitals require it. Under 42 CFR 482.43, a hospital's discharge plan must include a list of skilled nursing facilities that participate in Medicare, are available to the patient, and serve the geographic area the patient asks for. The hospital has to document that the list was presented.
The same rule protects the family's choice. The hospital must tell the patient or their representative about their freedom to choose among participating providers, and it "must not specify or otherwise limit" which qualified providers are available. It also has to help families choose by sharing data on each facility's quality measures and resource use, and it has to tell patients in managed care plans to check which facilities are in their plan's network.
In practice, that means the case manager hands over the list and the family decides. Some case managers go further. "The hospital social worker had given me a list of rehabs, but she actually marked three out of ten as better than the rest," one family member wrote on Reddit. But the pick is legally the family's, and the family is about to go looking.
Families Choose From That List in Hours, With Their Phones
The deadline is the defining feature. In the family threads we read, 18 people described getting the list and being asked to choose the same day or the next. "The hospital social worker was barking at us (again) to hurry up and pick a SNF," one wrote. Others described lists of 2 or 3 names, lists of 10 or 15, and lists limited to whoever had a bed that day.
What families do with those hours is predictable. They search the names. They look at Google reviews and, if someone tells them to, state inspection reports and Medicare's Care Compare. A few drive past to check for the smell Chapter 11 described. Then they call.
And the facilities are competing for the same patient at the same moment. Chapter 3 cited WellSky's finding that hospitals sent each patient's referral to an average of 6.6 facilities in 2024. When one patient is on six or seven desks at once, the building that answers first and says yes first has a real advantage.
The Family Types Your Name Into Google Straight Off the Hospital's List
The first thing a family does with the list is search each name. That search is the easiest one in the whole account to win, and it's surprisingly easy to lose.
The brand campaign from Chapter 2 exists for exactly this moment. When a family types your facility's name, your ad should sit at the top with a phone number that reaches admissions, and your Business Profile (Chapter 12) should fill the right side of the page with stars, hours and directions. Facility names are real searches. In Chapter 5's research, two campus names in our example market each drew about 2,900 searches a month.
Test it the way a family would. Search your exact name, your campus name if it's different, the name with "rehab" or "nursing home" after it, and the misspellings people actually type. Check what shows up on a phone. If a competitor's ad appears above your listing on your own name, or a directory site outranks you, the family's first impression is someone else's.
One more reason the brand campaign matters here: a family checking a name will often read its reviews in the same sitting, whether they search for them or just see the stars. Your ad can't change what the reviews say, but it can make sure the building's own voice, and its phone number, is on the page when they read them.
10 of 12 Local Nursing Home Sites Never Say When Admissions Picks Up the Phone
Once the family has searched, they call. So we looked at when the 12 nursing homes and campuses we studied in our example market, Pittsburgh, say their admissions line is answered.
One site labeled "24/7 Admission Support." One listed office hours of Monday to Friday, 9 to 5, plus Saturday from 10 to 2. The other 10 didn't say when admissions was reachable on any of the pages we checked. Several promised 24-hour nursing care, which describes the care, not the phone.
A family working through a list at 6 PM has no way to know which buildings will pick up. The ones that do get the admission. The reviews confirm how much this matters: in our sample, 13 reviews praised the admissions experience, 11 of them from rehab families, and the examples we quoted earlier in this guide were about speed.
Google Ads can help in three ways:
- Schedule the call asset to the hours someone actually answers admissions calls, so the ad doesn't show a phone number that rings out.
- Say the hours in the ad and on the landing page when they're a strength. "Admissions Answers Until 9 PM" is a reason to call first.
- Route after-hours calls to an on-call admissions phone rather than voicemail. Chapter 1 counts a voicemail as a real lead, and it is one. But a family racing a discharge deadline who reaches a recording often just calls the next name on the list.
Weekend Discharges Go to the Nursing Home That Can Admit on Saturday
Hospitals don't stop discharging on Friday afternoon. Chapter 1 quoted a family told around 4 PM on a Friday to pick a facility by 8 the next morning. It was one of the 18 same-day stories, and the timing was the part that stuck. A building that can only accept admissions Monday through Friday loses every Friday-afternoon list to one that can say yes on Saturday.
Saying yes on a weekend takes more than answering the phone. Someone has to review the referral, confirm the bed and the payer, and accept the patient. The practical answer is an admissions coordinator on call who can do all of that from home, with access to the referral, the bed board and the payer check. Without that person, a Saturday referral waits until Monday, and the family doesn't.
If yours can, say so. "Admissions 7 Days a Week" is one of the strongest lines a rehab ad can carry, and it belongs in the rehab campaign from Chapter 8. But only claim it if it's true every weekend. Families can check more than you might think: Medicare's Care Compare now reports weekend nurse staffing as part of each nursing home's staffing measures. A building that advertises weekend admissions and then sends Saturday calls to voicemail is making the kind of promise Chapter 8 warned against.
None of the 12 Sites Gave Case Managers a Way to Refer Online
The last gap is the one Chapter 1 promised to come back to. Case managers and discharge planners send the referrals behind many short-term rehab admissions, and none of the 12 sites we checked offered them an online referral form. The closest things were an admissions fax number on one site, a "referral" option buried in a general contact form on two others, and an instruction on one site for the case manager to call.
A simple referral page fixes that. Keep the form short: the case manager's name, hospital and callback number, patient initials rather than a full name for the first contact, the payer, the expected discharge date, and the care needs. Put the admissions direct line beside it, and the weekend hours if you have them.
Because a referral carries patient health information, the form has to run on a service built for it. Use a form vendor that will sign a Business Associate Agreement, the same standard Chapter 1 set for call tracking, and keep the patient details out of anything that reports to Google. What goes back to Google Ads is only that a referral happened, which lets the account count it as a conversion without sending any health information.
The page also gives your team something to hand out. Many rehab facilities send liaisons to visit patients and families on hospital floors. "I had no idea that rehabs have people who work the hospital floors," one family member wrote after a commenter explained it. A liaison with a card that points to a referral page and a number that answers on Saturday is doing the offline version of everything this chapter describes.
Next: Medicare, Medicaid and the Offers You Can Make
Chapter 15 covers the money questions families ask first: what Medicare pays for, how Medicaid fits, and which offers a nursing home can actually put in an ad.
Every chapter, from tracking through the hospital list and hiring, is on the guide's home page.
On the nursing home accounts we run in Google Ads management, the first question we ask admissions isn't about budget. It's who answers the phone at 6 PM on a Saturday. If you're running your own, call your admissions line this weekend and find out.
