The building had stood for over a century, its structure carrying the proportions and detailing of its period: high ceilings, generous room heights, and a staircase whose scale still defines the entrance sequence. Its roof was original timber construction, past the point of repair. Its window and door joinery, though structurally sound in form, had aged beyond use. The interior layout, unchanged since its years as patient wards, needed to become functional office space without altering the partitioning that had defined it for a century. The building sits within the Sotiria Hospital campus in Goudi, a complex where several buildings are officially listed as heritage structures. Spiliopouleio itself is not individually listed, but the design needed to hold that same architectural standard.

The roof was rebuilt, matching the original pitch and profile. Window and door joinery was retained in its original wooden design and rebuilt in aluminium to the same proportions and detailing. Marble was preserved throughout the building, on the staircases, landings and thresholds. Floors were laid in heavy-duty vinyl in a mosaic pattern referencing the building's period. The room layout was kept exactly as it stood: spaces that functioned as patient wards now function as offices, with no change to the original partitioning. An accessibility study was carried out to bring the building in line with contemporary requirements for people with disabilities, integrated without disrupting the historic room proportions or circulation.