Does HBO care about ratings? On the one hand, the premium cable channel has a bona fide hit like Game of Thrones, which has seen its rabid viewership continue to grow year after year, reaching a new high of more than 8 million viewers for its fifth season finale this past spring. On the other end of the spectrum is a little show called Getting On.

This Sunday, Getting On, a small-scale, low-budget dark comedy set in an extended care unit in Long Beach, California, begins its third and final season. HBO gave the show one more six-episode pickup this past year despite the fact that it was one of the network’s lowest-rated shows in its second season, averaging just 250,000 viewers per episode. Stephen Merchant’s Hello Ladies, which had nearly double that amount, was canceled after just one season.

The decision to let the show end its run on its own terms demonstrates just how much faith HBO has in Getting On, which was created and written by Mark V. Olsen and Will Scheffer, who also helmed Big Love for the network. And it should give those who have dismissed the show up to this point good reason to start binging on it now.

Getting On stars three women who are all comedy legends in their own right. Laurie Metcalf (Roseanne) is the self-involved Dr. Jenna James, who cares more about her pharmaceutical company-sponsored research than she does about the elderly patients who she is supposed to be treating.

Alex Bornstein, of MADtv and Family Guy fame, delivers by far the most nuanced performance of her career as Dawn Forchette, the ward’s head nurse who turns out to be far less optimistic and empathetic than she initially seems.

And then there is Niecy Nash (Reno 911!) who serves as the perfect audience surrogate. Starting with her first day on the job in the pilot, her nurse Denise “DiDi” Ortley remains the only truly sane and compassionate character on the show. Every time Getting On starts to veer into a place that simply feels too brutal to bear, Nash will have a quiet moment with one of her patients that re-grounds the show in reality and breaks your heart at the same time.

Over the course of its first two seasons, Getting On has also been the rare platform for older actresses (and the occasional actor) to perform broad comedy with just enough devastation lurking beneath the surface. We’ve seen Oscar-nominee June Squibb (Nebraska) as a vulgar, racist, homophobic patient who tortures the staff and tries to escape the hospital. In another episode, the nurses are tasked with keeping Ann Guilbert’s Birdy from fornicating in public with her visiting boyfriend, played by Harry Dean Stanton.

As the third season begins, Dr. James is participating in mandatory ethics training and fighting to keep her job following a fraudulent hospice program she had been helping spearhead. Dawn is facing the unfortunate reality of her impulsive decision to marry a hospital security guard for the sole purpose of making her once-lover and current co-worker Patsy De La Serda, played by The Last Man on Earth’s Mel Rodriguez, jealous.

And as always, DiDi is trying to find a way to take the “high road,” to rise above the bureaucratic bullshit, and just do her job. After Patsy vomits on the floor and tries to pass it off as a patient’s, DiDi resists the urge to simply clean it up herself. She succumbs to a needlessly complex union system that is best represented by a scene in which several nurses and orderlies argue over whose job it is to clean up misplaced bodily fluids as poor Birdy nobly struggles to get her arm through the sleeve of her sweater.

Nearly every episode of Getting On deals directly with death, making it perhaps the saddest comedy on TV—and even more cringeworthy than HBO classics of the genre like Curb Your Enthusiasm and The Comeback—and the Season 3 premiere is no different. But thanks to a new “personalized physician remote unit” program, this time the characters don’t actually have to come face-to-face the deceased. “It’s the same old me as on the phone, but now I’m a robot,” Dr. James tells a patient shortly before she expires.

By the end of the episode, Metcalf’s James, consistently the least likable character on the show, is moved enough by the loss of this patient that she seemingly resolves to do whatever it takes to avoid getting thrown under the bus herself. Recounting the story of a Hindu patient who once vowed to do more good deeds with the time she had left in order to avoid being reincarnated as a cat, she says, “We should all be ashamed to die until we’ve scored some victory for humanity. And time’s a wastin’.”

If you want a quick way into Getting On before Sunday’s premiere, look no further than this clip from the pilot episode of the series in which Bornstein’s Dawn and Nash’s DiDi attempt to diagnose an elderly Cambodian patient by futilely repeating what she is saying into the phone for a translator. It’s not just one of the funniest scenes in this show, it might just be one of the straight-up funniest TV moments of all time.