Food Safety: Grading NYC's New Health Inspection Policy

John Lawn

Elliott Marcus

New York City has one of the densest concentrations of restaurants, eateries and onsite dining facilities in the country, and its Public Health Department conducts over 70,000 health inspections of them each year. In March, the City's Board of Health gave its final approval to a regulatory initiative which in July will begin requiring all restaurants to publicly display letter grades summarizing their most recent inspection scores.

That means every customer will see your grade as he or she walks up to the front door of your establishment or cafeteria. And the new rule does include cafés and dining rooms in colleges, B&I and many other onsite facilities.

NYC's Health Department already posts numerical score inspection reports that document the number and severity of sanitary violations on its website. In contrast, the new program will “distill” those scores into letter grades and give them a public visibility that has engendered plenty of criticism from the NYC foodservice community. For example, some operators argue that as a practical matter, the public's perception of the scores will be that they indicate an operation has either “passed” (displaying an “A”) or failed (displaying any other grade), even if the difference between the two grades could be as minor as an additional point demerit for a leaking sink faucet.

The Department estimates that, given its most recent inspection scores, 30 percent of the city's restaurants would receive an “A” under the system; that 40 percent would receive a “B” and that 24 percent would receive a “C.” When Los Angeles implemented a similar system, the number of restaurants qualifying for an “A” grade doubled to more than 80 percent in a short period of time, a result NYC's health department says it would also like to see.

The Department has been at the center of many controversial policies that affect restaurants, including a 2008 ruling that requires chain restaurants to post calorie content of their offerings on menus and menu boards.

Overseeing the implementation of these policies is the Department of Health's Associate Commissioner, Food Safety and Community, Elliott Marcus, who has overseen the city's health inspection services for nine years. We recently interviewed Marcus in the department's offices in downtown Manhattan to get his take on why such a policy is necessary and whether it fairly treats the city's foodservice community.

Practically speaking, what does the Health Department hope to accomplish with the new grading program?

It is really pretty simple — many restaurants do well in inspections, but we would like to see those that don't, or those that only barely get a passing grade, improve. We have posted inspection scores on the website for three years, so what has really changed here is only the requirement that the scores be posted at the restaurant itself. When they started doing this in Los Angeles, the percentage of failing and low scores began to fall off quickly.

So your goal is to change behavior?

We are not so much interested in changing behavior with the letter grades, but in improving compliance with the health code. If that means a restaurant adds additional staff to oversee sanitation, or implements more active management controls, I guess that would be a behavioral change for the institution. But our main goal is improved compliance.

Some have argued that the L.A. experience generated a form of “grade inflation,” with inspectors becoming sympathetic to and not wanting to stigmatize those with borderline scores…

We are aware of that effect. Some years ago we began evaluating our statistics very closely in terms of how many restaurants here were getting scores of just under 27 [Ed: 27 is the violation point score in NYC that requires a compliance inspection]. When our inspectors knew we were looking closely at that, the statistical curve began to look much more like the curve you would expect. If some were being sympathetic, we think we nipped that in the bud. We don't view it as a conscious thing, just probably human nature. It is a tough job to go out there and tell people they have food safety violations.

How do you answer those who say the public will view an “A” grade as a passing grade, and any other grade as a de facto failing grade?

We consider “A,” “B” and “C” to be passing grades. If an operator has earned a “B” or a “C,” we want the establishment to do better. We don't want diners to be the canaries in the mine — we do serious inspections to keep people from becoming seriously ill when they go out to eat.

We look at this whole process as part of a contract between the city and the operators. That is, the city gives them permission to operate restaurants and requires them to have someone who has taken a food safety protection course on duty at all times during operation to ensure that it is in compliance with the rules.

When we show up once or twice or even three times a year, and find they are not in compliance, we can only assume that the rest of the year they are not in compliance either. [Ed: NYC inspections are more frequent if a restaurant receives a lower grade.]

Is it fair to evaluate operators of large facilities like colleges and business dining operations, which may have multiple pantries, kitchens, dining rooms and points of service, with the same point system you use for a 1500-sq.ft. storefront restaurant?

We do not offer a dispensation based on the size of a facility. Food safety is food safety and a violation is a violation.

If you are an operator, it's your business to decide how you want to run your operation. If you run a larger facility, you may need to have more than one person assigned to monitor all the areas that might cause you to have violations.

When we are questioned about this, I say — you want us to give you a break because you are larger? Our inspectors receive a simple marching order, ‘Cite What You See.’ If an operator believes an inspection mistake has been made, there are multiple opportunities to contest it via our administrative tribunal.

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What if I want to contest a letter grade in the new system?

Initially, we will only give out grades if you get an “A.” If you score lower, you will get two or three weeks to fix your violations and then will have another unscheduled re-inspection. There is no reason you shouldn't be able to get an “A” since you will know the violations cited in the original report.

At that point, we will hand out a letter grade card and a ‘Grade Pending’ card, either of which may be posted until you have had a chance to be heard by the administrative tribunal. But if the tribunal finds against you, or you don't show up at the hearing, you must post the original grade.

Won't you need more staff to monitor the grade postings?

We already have a separate staff to make sure operating permits are present, and they will also monitor the grade postings. I think there will be plenty of members of the public who will be checking to ensure that posted grades match the scores on our website.

Do you believe this program will influence how other cities look at the way food safety inspections should be managed?

I think all of our efforts to improve public health in New York City attract a significant amount of attention, both nationally and internationally, and that if our experience leads to stronger public health initiatives in other places, that is a good thing.

For more information on the NYC grading system, go to www.nyc.gov/html/doh/html/home/home.shtml