diff --git a/nirc_ehr/resources/queries/study/cases.js b/nirc_ehr/resources/queries/study/cases.js
index f5c88d96..a645e309 100644
--- a/nirc_ehr/resources/queries/study/cases.js
+++ b/nirc_ehr/resources/queries/study/cases.js
@@ -29,8 +29,7 @@ EHR.Server.TriggerManager.registerHandlerForQuery(EHR.Server.TriggerManager.Even
             triggerHelper.closeDailyClinicalObs(row.caseid, row.enddate);
         }
 
-        var reopen = oldRow && oldRow.enddate && !row.enddate;
-        if (!helper.isValidateOnly() && (reopen || helper.getEvent() == 'insert') && row.caseid && row.Id && row.performedby && row.taskid && row.category == 'Clinical') {
+        if (!helper.isValidateOnly()) {
             var qc;
             if (row.QCStateLabel) {
                 qc = EHR.Server.Security.getQCStateByLabel(row.QCStateLabel);
@@ -42,13 +41,37 @@ EHR.Server.TriggerManager.registerHandlerForQuery(EHR.Server.TriggerManager.Even
             if (!qc) {
                 console.error('Unable to find QCState: ' + row.QCState + '/' + row.QCStateLabel);
             }
-            else if ((qc.Label == 'Completed' || qc.Label == 'Review Required') && row.caseid && row.Id && row.performedby && row.taskid && qc) {
-                var ordersInTransaction = helper.getProperty('ordersInTransaction');
-                var oit = [];
-                if (ordersInTransaction && ordersInTransaction.length) {
-                    oit = ordersInTransaction;
+
+            // Don't allow taking an existing non-draft case back to draft
+            if (oldRow && qc.Label == 'In Progress') {
+                var oldQc = EHR.Server.Security.getQCStateByLabel(oldRow.QCStateLabel);
+                if (oldQc.Label != 'In Progress') {
+                    EHR.Server.Utils.addError(errors, null, 'Cannot save a draft copy of a case already opened or in review.', 'ERROR');
+                }
+            }
+            else {
+                var reopen = oldRow && oldRow.enddate && !row.enddate;
+                if ((reopen || helper.getEvent() == 'insert') && row.caseid && row.Id && row.performedby && row.taskid && row.category == 'Clinical') {
+                    var qc;
+                    if (row.QCStateLabel) {
+                        qc = EHR.Server.Security.getQCStateByLabel(row.QCStateLabel);
+                    }
+                    else if (row.QCState) {
+                        qc = EHR.Server.Security.getQCStateByRowId(row.QCState);
+                    }
+
+                    if (!qc) {
+                        console.error('Unable to find QCState: ' + row.QCState + '/' + row.QCStateLabel);
+                    }
+                    else if ((qc.Label == 'Completed' || qc.Label == 'Review Required') && row.caseid && row.Id && row.performedby && row.taskid && qc) {
+                        var ordersInTransaction = helper.getProperty('ordersInTransaction');
+                        var oit = [];
+                        if (ordersInTransaction && ordersInTransaction.length) {
+                            oit = ordersInTransaction;
+                        }
+                        triggerHelper.ensureDailyClinicalObservationOrders(row.Id, row.caseid, row.date, row.performedby, qc.RowId, row.taskid, oit);
+                    }
                 }
-                triggerHelper.ensureDailyClinicalObservationOrders(row.Id, row.caseid, row.date, row.performedby, qc.RowId, row.taskid, oit);
             }
         }
     }
diff --git a/nirc_ehr/resources/web/nirc_ehr/data/CaseStoreCollection.js b/nirc_ehr/resources/web/nirc_ehr/data/CaseStoreCollection.js
index c6058d9c..fbb226f2 100644
--- a/nirc_ehr/resources/web/nirc_ehr/data/CaseStoreCollection.js
+++ b/nirc_ehr/resources/web/nirc_ehr/data/CaseStoreCollection.js
@@ -167,9 +167,13 @@ Ext4.define('NIRC_EHR.data.CaseStoreCollection', {
                     cs.fireEvent('datachanged', cs);
             }, this);
         }
+        // Only validate once stores have loaded, otherwise can have perf issues when loading existing cases
+        else if( this.haveStoresLoaded ) {
+            // Validate across the sections, such as clin_remark not required if case close date entered
+            this.validateAll();
+        }
 
         this._cachedKey = cacheKey;
-        this.validateAll();
     },
 
     getTaskId: function(){
diff --git a/nirc_ehr/src/org/labkey/nirc_ehr/NIRC_EHRModule.java b/nirc_ehr/src/org/labkey/nirc_ehr/NIRC_EHRModule.java
index 5d8a06ef..f34bf769 100644
--- a/nirc_ehr/src/org/labkey/nirc_ehr/NIRC_EHRModule.java
+++ b/nirc_ehr/src/org/labkey/nirc_ehr/NIRC_EHRModule.java
@@ -180,6 +180,7 @@ protected void doStartupAfterSpringConfig(ModuleContext moduleContext)
 
         EHRService.get().unregisterMoreActionsButtons("study", "treatment_order");
         EHRService.get().registerMoreActionsButton(new MarkCompletedButton(this, "study", "observation_order", "Set End Date"), "study", "observation_order");
+        EHRService.get().registerMoreActionsButton(new MarkCompletedButton(this, "study", "flags", "Set End Date"), "study", "flags");
 
         registerDataEntry();
         NotificationService.get().registerNotification(new NIRCDeathNotification());