PDF Download: Evaluation of the Community-Based Care Transitions Program Resource Library January 28, 2015January 28, 20150 PDF Download: Evaluation of the Community-Based Care Transitions Program Evaluation of the Community-Based Care Transitions Program, May 30, 2014; This First Annual Report PDF contains the introduction, program implementation, analysis and summary of the findings of the Community-Based Care Transitions Program. The Community-Based Care Transitions Program was created to assess metrics including readmissions, emergency department visits, observation stays, costs, patient experiences, and patient activation. Data draws from 46-48 sites, and the report examines outcome from the data collected in the project year.