Renovating electrical systems in existing healthcare facilities requires balancing legacy infrastructure, operational constraints, and evolving code requirements. Unlike new construction, remodel projects demand continuous decision-making in real-world conditions where design intent, constructability, and compliance must align within occupied and often constrained environments. This presentation examines electrical design and construction strategies for healthcare remodels, with a focus on how the 2026 updates to the FGI Guidelines and NFPA 70 influence project scope, system design, and renovation approaches. Particular attention will be given to identifying code-driven triggers that impact existing electrical infrastructure and essential electrical systems, often extending beyond the originally intended base scope of work. The session will also explore strategies to manage and, where possible, mitigate unnecessary scope escalation through early evaluation of existing conditions, informed interpretation of code requirements, and coordinated design decision-making. Emphasis will be placed on integrating constructability into the design process, ensuring engineering intent aligns with field realities in active healthcare environments. Finally, the presentation will address phased renovation approaches that maintain operational continuity while achieving compliance with current codes. This session is presented jointly by a design electrical engineer and an electrical contractor, offering both design and field perspectives on practical implementation challenges and real-world execution strategies. Through practical examples, attendees will gain actionable strategies for navigating the complexities of electrical upgrades in existing healthcare facilities while balancing compliance, constructability, and project delivery constraints.