Cost Per Lead Reduction
Monthly Lead Volume
Average Cost Per Lead
The Challenge
ComfortCare Home Health, a 28-caregiver agency in Houston, TX, was spending $4,000 per month on Google Ads with disappointing results. They were getting 15–20 leads per month at an average cost of $42 per lead — well above the industry benchmark — and half of those leads were from job seekers, not families seeking care.
Their previous agency had set up the campaigns years ago and was doing minimal management. The accounts had never been properly audited, and wasted spend was hemorrhaging their budget.
- $4,000/month ad spend
- 15–20 leads per month
- $42 average cost per lead
- ~40% leads were job seekers
- No conversion tracking
- Traffic sent to homepage
- No negative keywords
- No ad extensions set up
- $4,000/month ad spend (same)
- 60–70 leads per month
- $14 average cost per lead
- <5% non-qualified leads
- Full conversion tracking
- 3 dedicated landing pages
- 285 negative keywords added
- All extensions fully configured
The Audit Findings
Our initial audit of their Google Ads account revealed several critical issues that were destroying their ROI:
- Broad match keywords without negatives — Ads were showing for "caregiver jobs," "home care training," and "home care certification" — job seekers, not clients
- Sending all traffic to the homepage — A cluttered homepage with navigation links was causing 87% bounce rate from ad traffic
- No call tracking — They had no idea which keywords or ads were generating actual phone calls
- No ad extensions — Missing call extensions, location extensions, and sitelinks that could dramatically improve CTR and quality score
- Campaigns running 24/7 — Budget was being wasted overnight when intent is lowest
- No automated bidding strategy — Using manual CPC without conversion data
Our 90-Day Transformation
Week 1–2: Account Restructure
- Rebuilt campaign structure from scratch with tightly themed ad groups
- Switched from broad match to phrase match and exact match keywords
- Added 285 negative keywords immediately
- Set up comprehensive call tracking and conversion goals
Week 3–4: Landing Pages
- Built 3 dedicated landing pages — one for "home care," one for "home health," and one for "dementia care"
- Each page had a click-to-call button, a short lead form, and 5 trust signals above the fold
- Removed all navigation menus to keep visitors focused on converting
- Added Google Local Services badge and review score to each page
Month 2: Optimization & Scaling
- Enabled Smart Bidding (Target CPA) with accumulated conversion data
- Set ad scheduling — ran ads 6am–10pm, Mon–Sat when intent is highest
- A/B tested 3 headline variants per ad group
- Added geographic bid adjustments for highest-value zip codes
Month 3: Advanced Optimization
- Set up Google Local Services Ads (LSAs) alongside Search campaigns
- Implemented audience layering — bid higher for past website visitors
- Created a remarketing campaign targeting website visitors who didn't convert
Results by the Numbers
💡 The higher Quality Score alone saved them money — Google rewards relevant, well-structured ads with lower cost-per-click. Their average CPC dropped from $8.40 to $3.60, meaning the same budget bought more than twice as many clicks.
Client Testimonial
"The Google Ads team cut our cost-per-lead in half while doubling our volume. They actually understand healthcare marketing — not just marketing in general. They knew which keywords to target, which to block, and how to write ad copy that speaks to families who are worried about their parents. The difference was immediate."