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Throughout history, buildings have been considered passive containers in which occupants’ activities take place. New sensing technologies enable buildings to detect people presence and behavior. At present, this information is mostly used to trigger reactive responses, such as heating and cooling operations. We argue that truly smart environments can leverage sensed information to proactively engage with the occupants and inform decision making processes with respect to which activities to execute, by whom and where. Such ability will transform buildings from passive to active partners in the daily lives of their inhabitants. It stems from the omniscience of sensor-equipped buildings that will “know” all that is happening everywhere within (and around) them at any given moment and can predict, through simulation, the expected consequences of alternative operational decisions. Such ability is mostly relevant for hospitals and other complex buildings, where actions taken in one part of the building may affect activities in other parts of the building. We are developing a simulation-powered building management system that resolves space, actor and activity-based conflicts while harnessing data collected via visible light communication. We demonstrate this approach in a case study in the catheterization lab of a major hospital.