Sonoma County Will Require Masks in Nursing Homes, Dialysis and Infusion Centers Starting Nov. 1

Anyone visiting a relative in a Sonoma County nursing home this winter will need to wear a mask in patient areas. County Health Officer Dr. Mia Shim issued an order Wednesday requiring health care workers and non-patients, including visitors and people accompanying patients, to mask in patient care areas of certain high-risk facilities during respiratory virus season.

Where and when

The order takes effect at 12:01 a.m. on Nov. 1 and runs through March 31, 2027, though the health officer can shift those dates based on virus surveillance data. It covers skilled nursing facilities, the parts of long-term care facilities where nursing care is provided, acute and non-acute rehabilitation facilities, infusion centers and dialysis centers. The county can add other types of facilities if surveillance data calls for it.

Patient care areas include registration desks in lobbies, waiting rooms, exam rooms and therapy rooms. Cafeterias and gift shops are not included. The requirement applies regardless of vaccination status.

What counts as a mask

Under the order, only surgical masks and KN95, KF94 or N95 respirators qualify. Cloth masks, bandanas, scarves, gaiters and masks with exhaust valves do not. Facilities must post signs at entrances to patient care areas and provide masks to their staff. Exemptions include people with medical conditions or disabilities that prevent masking, people communicating with someone who is hearing impaired, and workers for whom a mask would create a job safety risk. Violating a health officer order is a misdemeanor under state law, the order states.

Why the county does this

The county has required some form of seasonal masking for health care workers since 2017, and this year's order continues the 2025 rules. The order says patients in these settings, especially older people and those with chronic illnesses, face the highest risk of being hospitalized or dying from flu, COVID-19 and other respiratory viruses, and that sick health care workers can strain limited medical resources.

Shim also urged everyone 6 months and older to get updated COVID-19 and flu shots, plus RSV vaccines for those eligible. She noted those vaccines remain covered by insurance in California, and encouraged masking in indoor public places when local transmission is high. The county posts current levels on its respiratory virus dashboard.