Generally, every nursing home has a dedicated physician and you are prohibited and discouraged from using any outside physician, unless granted an exception. Furthermore, insurance covering the nursing home does not permit coverage for "additional help" from outside. I have hired outside help, at the cost of the patient, to supplement coverage in a nursing home, albeit not without resistance. You have to pay for them youself and there will be likely be internecine warfare between them and the regular nursing home staff. There are enough unemployed health care workers around so you won't have any problem hiring them. One of them has to be designated overall-aide-in-charge.
There is also another problem in many states. New legislation requires you to hire a "care coordinator" and you may no longer be able to deal or hire directly from the various providers if they will be covered by insurance. This is the perfect solution to which no known problem existed and is the case in NewYork.