The Patient Centered Medical Home (PCMH) is not an actual building, house, or hospital. It is a team approach to healthcare that incorporates patients’ primary care provider, specialists, patient and patients’ support people.

The clinic has a Patient Centered Medical Home Care Coordinator who is a registered nurse dedicated to work together with a patient's primary care provider, their care team, and the patient, to assist with ongoing guidance, education and support. (As of 2025, this position is vacant but we are currently hiring. Please visit Ldf Tribe Employment Page )

This voluntary service provides access to the coordinator who will regularly: 

• Serve as a point of contact and help navigate the health care system by referrals to specialists, coordinating appointments, testing and follow ups
• Be an informational resource to help the patient understand diagnoses, treatments and test results
• Review medications to help the patient understand them and why they've been directed to take them
• Facilitate access to resources in the Medical Home and in the community
• Assist with access to health care equipment and supplies
• Help to set and achieve goals to improve health
• Coach and support the patient to take an active role in their healthcare
• Promote independence in medical decision making