One busy evening at the Flatiron Room on West 26th Street, a man walked in and announced to the restaurant's staff that he was there to do a health inspection.
He surveyed every corner of the restaurant, from liquor bottles to egg cartons, and checked the temperature of refrigerators and dishes on the line.
The man, though, wasn't a city Health Department inspector whose report determines the letter grade plastered in a restaurant's windows. He was a restaurant consultant performing a mock inspection so that the eatery would be ready for the real thing.
Flatiron Room owner Tommy Tardie has an inspector from Letter Grade Consulting come once a month because he believes a lot rides on what grade his year-old restaurant gets.
"I'm guilty of it. I definitely use [letter grades] as a deciding factor," said Mr. Tardie, whose restaurant has an A and has been using the consultants for four months. "If I'm walking somewhere and I'm looking for a quick bite to eat, and one is a B and one is an A. It's a no brainer. I'm going to go to the A."
The Health Department's grading program was established in 2010 and has become popular with the public—if not the restaurant industry. A 2012 Quinnipiac University study found 82% of respondents support the use of letter grades to evaluate restaurants and 67% consider letter grades when deciding where to eat.
And the grades are becoming even easier to access. In early 2012, the Health Department introduced a smartphone application, which searches all 24,000 restaurants it inspects for letter grades, scores, and all health violations. The app has been downloaded 44,000 times, according to the Health Department.
The business review site Yelp plans to shine even more light on the process by introducing inspection results along with reviews in New York City.
The pressure to pass the inspections leads restaurant owners to seek out restaurant consultants, who can charge $250 for a one-time mock inspection or thousands of dollars for yearly contracts with larger restaurants—including representation at hearings where violations can be contested.
The fear of the "scarlet letter"—plus the steep fines associated with a poor inspection, which can range from $200 to $2,000 a violation—have helped boost business, said Rada Tarnovsky, who opened Letter Grade Consulting, with fellow lawyer Leon Lubarsky last spring.
Mark Nealon, a former health inspector who started a company called SAFE Restaurants 20 years ago, said his business has shifted since the letter grades.
"It used to be very important to do the inspection and get somebody prepared. That has taken a back seat to, 'Oh my God we just got a B or a C from the Health Department.'"
Besides pointing out potential violations, consultants find themselves educating restaurant owners about the idiosyncrasies of the system. Violations that seem alarming, such as evidence of mice, might not cost a restaurant an A rating. At the same time, something that seems minor, such as not having a person on site with a food-protection certificate, awarded by the city after completing an approximately 15-hour course, are deemed more severe.
Last-minute slip-ups also can cost restaurants big, the consultants said.
"The most common violations that we see are wiping cloths being left on the prep table and something foreign in the hand wash sink" that suggests the sink is being used for washing dishes, said Mr. Lubarsky from Letter Grade Consulting. These violations can deduct from five to 10 points from a restaurant's inspection score. A restaurant that receives more than 13 points in deductions cannot earn an A rating.
Consultants also help restaurants grapple with violations that seem to defy traditional cooking methods. Sushi chefs might opt to ignore the bare-hand contact rules and make sure to consistently wash their hands instead, as is customary. If the bare-hands violation is the only one, a restaurant can still earn an A, said Ms. Tarnovsky.
The Health Department doesn't work with any outside consultants but does have several programs to help restaurants prepare for inspections, including a training program, guides and a help line. The department will soon offer an ungraded, penalty-free inspection that could "improve a restaurant's ability to implement good food safety measures and earn an A grade," according to a Health Department spokesman.
The stakes of the letters grades have been raised even higher, Ms. Tarnovsky and Mr. Lubarsky have observed, by some landlords who draft contracts and leases stipulating that restaurants must maintain an A grade. If a restaurant slips below an A, it could default.
Francesco Nuccitelli, the general manager at Sociale, a new Italian restaurant in Brooklyn Heights, hired Letter Grade Consultants after the restaurant's initial ungraded inspection for new establishments set the restaurant back more than $1,300. When the Health Department came back for a graded inspection, he was prepared: A mock inspection had taken place days before, and the restaurant earned an A.
"I didn't have this feeling of anxiety killing me," he said. "I could dedicate to what I'm supposed to do in the restaurant, which is entertain my guests and giving them the right food, getting my orchestra playing a nice melody."