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EDMUND G. BROWN JR.
Governor

Health and Human Services Agency
California Department of Public Health


AFL 25-28
October 7, 2025


TO:
Skilled Nursing Facilities (SNFs)

SUBJECT:
Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory Viral Infections in California Skilled Nursing Facilities – 2025-26   

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​All Fa​cilities Letter (AFL) Summary

This AFL notifies facilities of an updated version of the guidance document “Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory Viral Infections in California Skilled Nursing Facilities – 2025-26​​​” (PDF)​, which provides recommendations and strategies that can be broadly applied for the prevention and control of COVID-19, influenza, respiratory syncytial virus (RSV), and other common respiratory viruses (e.g., adenovirus, parainfluenza virus, etc.) in California SNFs.​

​SNF residents remain at increased risk for severe disease, hospitalization, death, and outbreaks caused by SARS-CoV-2 (the virus that causes COVID-19), influenza, RSV, and other respiratory viruses. In this year's guidance for SNFs, the California Department of Public Health (CDPH) continues to emphasize the following key messages:

  1. Encourage residents and healthcare personnel (HCP) to stay up to date on recommended vaccinations to prevent morbidity and mortality from respiratory infections in SNFs.
  2. Maintain policies for source control masking with well-fitting facemasks or respirators that cover a person's mouth and nose to reduce respiratory virus transmission in healthcare settings.
  3. Initiate prompt testing and treatment of COVID-19 and influenza to reduce the risk of severe illness, hospitalization, and death.

In addition, this year's guidance document includes the following updates:

SNFs should review the updated “Recommendations for Prevention and Control of COVID-19, Influenza, and Other Respiratory Viral Infections in California Skilled Nursing Facilities – 2025-26​​” (PDF) to ensure readiness for the upcoming winter respiratory virus season. 

Establishing or maintaining lines of communication between SNFs and their local health department will help facilitate support in the event of an outbreak, vaccine or antiviral agent shortage, or testing and personal protective equipment supply needs. SNFs must report outbreaks to their local health department and CDPH district office.

For questions about this guidance document, please contact the CDPH Healthcare-Associated Infections Program at HAIProgram@cdph.ca.gov.

 

Sincerely,

Original signed by Mandi Posner

Mandi Posner

Deputy Director​

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