A healthy Google Ads account usually has a good click-through rate, meaning people are actually clicking the ads after seeing them. The keywords match what the ads say, and the landing page, which is the page people go to after clicking, matches both. A struggling account often has low quality scores, which is Google's way of rating how relevant your ad is, wasted budget on keywords that do not convert, and very little testing of new ads. What has been your experience managing an account like this?