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“Smart” buildings that can sense and detect people’s presence have been in use for the past few decades, mostly using technologies that trigger reactive responses such as turning on/off heating/ventilating, lighting, security, etc. We argue that to be considered truly smart, buildings must become “aware” about the locations and activities of their inhabitants so they can proactively engage with the occupants and inform their decision making with respect to which actions to execute, by whom and where. To help assess the potential impact of “aware” buildings on their occupants, we are developing a multi-agent simulation-powered building management system that can sense human and building assets, extrapolate patterns of utilization, simulate what-if scenarios and suggest changes to user activities and resource allocation to maximize specific Key Performance Indicators (KPIs). The system is able to evaluate the implications of potential conflict resolution strategies and account for individual and collaborative activities of different types of users in semantically rich environments. Sensing in our case is based on Visible Light Communication (VLC) technology, embedded in a building’s LED lighting system. It can detect the actors, where they are located and what they do. To understand what happens in each space at any given time the information derived from the VLC system is combined with models of users’ activity schedules, profiles, and space affordances. We demonstrate our approach by hypothetically applying it to a Cardiac Catheterization Laboratory (CCL). The CCL is high-intensity hospital unit, second only to the Emergency Department in terms of the urgency of the cases it must handle. An aware building will help both patients and staff to allocate their (always scarce) resources more efficiently, saving time and alleviating stress.