What is Jamestown trying to be? They seem to fit a niche being a hub for agriculture between Bismarck and Fargo. My wife is from there. We visit her parents a lot in Jamestown. I don't see them trying to be anything but what they are and keeping up with the times. It doesn't have to grow, but it has to develop infrastructure to maintain modernity. The hospital serves the surrounding area. What would you like it called? Does Cleveland have a hospital? It seems the airport is pretty regional if you lived in the region.
The bottom line is I am not sure what you are saying in your post. What is Jamestown trying to be that it isn't.