LBMS adoption in California is steadily increasing. Several hospital case studies have been reported earlier but they have mainly focused on numerical measures related to LBMS. The previous research has highlighted the need to better understand the social aspects related to implementation. The case study reported in this paper presented a unique opportunity to develop social processes because the owner was involved from the beginning and was prepared to change their standard process. The project goals included using a model-based cost plan to inform the schedule with quantities and cost per location, using LBMS to plan efficient labor flow and control production, as well as running pull planning sessions with subcontractors to collect input from those closest to the work. The challenges included creating integrated deliverables quickly and keeping them up-to-date with the evolving design, training the extended project team and helping the team resist the urge to fall back to traditional behaviors during crunch points. It was crucial to understand the role traditional CPM tools play in a project and determining how these tools should interact with the LBMS schedule. To facilitate training, research was performed to understand and document why superintendents and subcontractors behave as they do on traditional projects and the changes required from both roles in order for the new systems to work.