Recently, I was reminded of the benefits of thorough documentation for quality measures. In November 2016 an 87-year old female who had suffered an ischemic stroke was discharged home without any anti-coagulant medication, which is recommended best practice. This omission put my institution in jeopardy of losing its national stroke center designation. After searching through numerous progress notes, electronic prescriptions and the discharge summary, we recovered an addendum to the discharge summary where the physician documented his reason for not prescribing an anti-coagulant to this elderly patient. This clear documentation saved our institution from losing the stroke center designation. What appeared to be huge case of negligence was cleared up with proper clinical documentation.