Go back to the two families from Chapter 1. The daughter in the hospital hallway and the son who has been driving to his father's house every night for eight months are headed for the same kind of building. They reach it through completely different searches, and they're at completely different points when they type them.
Marketing people call those points the awareness funnel. Somebody who doesn't yet know they have a problem sits at the top. Somebody who knows exactly which place they want sits at the bottom. The usual advice is to start at the top and build awareness. For a nursing home's Google Ads, that's backwards. The searches at the bottom are bigger, cheaper per admission and closer to a phone call, and that's where a new account should spend first.
A Rehab Family Starts at the Bottom of the Funnel, Holding the Hospital's List
Most families walk down the funnel one step at a time. A rehab family gets dropped in near the floor.
It happens in an afternoon. A case manager hands over a list of nursing homes with open beds, and the family's next searches are the names on that list. In our example market, Pittsburgh, a single campus name can draw thousands of searches a month: "concordia cabot pa" and "friendship village of south hills" each show 2,900 in Keyword Planner. Your market's names will be different, but the pattern holds anywhere hospitals discharge to skilled nursing. Families also check those names against Medicare's own ratings. "Medicare nursing home compare" gets 2,900 searches a month nationally.
The long-term family is the one who walks the whole way down. Their first searches aren't about nursing homes at all. "Caregiver burnout" gets 5,400 searches a month. "Caring for aging parents" gets 390. From there they drift toward the questions: is it time, what's the difference between assisted living and a nursing home, who pays. Only after that do they search for a building.
Families Search "Medicaid Nursing Home" 18,100 Times a Month. That Search Isn't an Admission Yet.
The middle of the funnel is where the long-term family asks about money. In the US each month:
- "medicaid nursing home": 18,100
- "nursing home vs assisted living": 5,400
- "does medicare pay for nursing home": 4,400
- "nursing home cost": 3,600
- "how much does a nursing home cost": 1,900
- "how to pay for nursing home": 880
Those are big numbers, and the clicks are cheap. Most top-of-page bids for them sit under $6. It's tempting to buy them all.
Don't start there. A family searching "does medicare pay for nursing home" is doing homework, and homework can take months. Some of them are asking for a parent who will end up in assisted living, at home, or in another state. Pour a launch budget into them and the report fills with clicks while the admissions line stays flat, which is exactly the kind of result the tracking from Chapter 1 exposes.
These questions still matter. They're what families want answered before they call, and the pages that answer them well make every other ad work harder. Chapter 15 covers how to answer the Medicare and Medicaid questions honestly in your ads. For now, the point is order: answer them on your site, and buy them later.
"Nursing Homes Near Me" Gets 201,000 Searches a Month. "When Is It Time" Gets 110.
Here is the whole argument in two numbers. Across the US, "nursing homes near me" gets 201,000 searches a month. "When is it time for a nursing home" gets 110. The family asking whether it's time is a real person with a real problem. There are just far fewer of them typing it into Google, and by the time the rest are searching, they've already decided.
The bottom of the funnel isn't one search, either:
- "nursing homes near me": 201,000, top-of-page bids $2.33 to $9.03
- "long term care facility near me": 8,100
- "best nursing homes near me": 2,400
- "short term rehab near me": 1,000
The word "best" in the third search is a clue about what families check next. They want proof, and the proof they reach for is usually Medicare's star rating or the reviews on your Google listing. Chapters 8 and 12 come back to both, because an ad that answers the "best" question before the family asks it is a different ad from one that lists amenities.
Look at the last one. It's the smallest of the four and the priciest, with bids reaching $35.56, because addiction treatment centers fight over "rehab" as well. Chapter 5 sorts that out. For planning, it means the family word "nursing home" is where a small budget goes furthest.
In our example market the same shape holds: "nursing homes near me" and its close variants get 2,400 searches a month in Pittsburgh at $2.09 to $10.11, while "time for nursing home" shows zero. That's the real answer to "how fast do families move?" Nobody has measured the days between stages. The volumes say most families spend very little time in the question searches, and rehab families skip them entirely.
Timing matters a little too. Google Trends shows consumer nursing home searches running about 6% above normal in July, and Thanksgiving week is the quietest week of the year, roughly 15% below. Neither swing is big enough to change the plan, but it's worth knowing before you read a slow November as a broken account.
The Hospital's Discharge List Sends Families to Google to Search Your Name
The rehab family's first search is your name, typed straight off the case manager's list. The long-term family searches your name after a friend mentions you, or after they drive past. Either way, the search that names your building is the most valuable click you can buy, and it's usually the cheapest.
So your facility's name gets its own campaign from day one, separate from everything else. It's defensive: when a family searches your name, the first thing they see should be you, with your phone number, and not a referral site or the facility across town that bid on your name. It also sends Google its earliest clean signals, because the people clicking a brand ad are mostly the people who were going to call anyway.
Add a physician's or administrator's name only if families actually search it. Check Keyword Planner first; for most nursing homes, the facility and campus names are what people type.
Search and Your Brand Campaign Launch First. YouTube and Performance Max Wait for Volume.
Every stage of the funnel asks the marketing to do a different job. At the top, the job is to create awareness: a caregiver who has never thought about a nursing home learns that you exist. A step down, it's to drive interest: the family starts reading about levels of care. Further down, it's to influence the decision: your building makes the shortlist over the one across town. At the bottom, it's to compel action: somebody picks up the phone today.
A new account can only afford one of those jobs well, and the last one pays for the rest. Every Google channel matches a stage, and the order you turn them on matters more than the list.
- Most aware (they know your name): the brand campaign. Launch day.
- Service aware ("nursing homes near me"): Search, starting with exact match on the searches you know turn into calls. We call that the Isolation campaign (our name for it), and Chapters 5 and 6 build it. Launch day.
- Solution aware (the Medicare and Medicaid questions): broad match in a second Search campaign we call Exploration, once Isolation brings in about 30 quality conversions a month. A bigger budget gets there in weeks; a small one can take months.
- Problem aware ("caregiver burnout"): Demand Gen and YouTube, and later Performance Max, once the account holds that volume with both Search campaigns running. Chapters 10 and 11 cover them, including the extra limits nursing homes face there.
One tool is missing from that list. By our reading of Google's policy, its health rules keep remarketing, Customer Match and lookalike audiences away from care like this, because they cover conditions that need long-term care and ads aimed at caregivers. You can't follow last week's website visitors around the internet with nursing home ads, and you shouldn't want to.
Is there ever a reason to start higher up? Yes, if the budget is big enough to fund the bottom fully and still have money left. Most nursing homes don't start there, and the bottom of the funnel will use every dollar you give it for a while.
Next: Price Each Click by What an Admission Is Worth
Knowing where to spend comes before knowing how much. Chapter 3 prices the click from the admission backward, with a Medicare rehab stay and a Medicaid resident on separate math.
Every chapter, from tracking through the hospital list and hiring, is on the guide's home page.
Every nursing home account we take on in Google Ads management opens the same way: the facility's name and the near-me searches, with the Medicare and Medicaid questions held back until the account proves it can fill beds. If you're doing it yourself, pull up your search terms report and count how many of last month's clicks came from families who typed a building or a "near me."
