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Step 1
Heat a large skillet (one with a lid) over medium to medium-high heat, and add the smoked sausage. Saute until browned well — if you need a little oil because it starts to stick, add a drizzle. Remove from the pan, and set aside.
Step 2
In the same skillet over medium heat, add the olive oil and onion. Saute until tender, about 5 minutes. Add the garlic, and cook until fragrant, about 30 seconds.
Step 3
Add the broth, and scrape the pan to loosen any browned bits.
Step 4
Add the diced tomatoes, water, dry pasta, salt, and pepper. Stir to combine well.
Step 5
Bring the mixture to a simmer, add the lid, and simmer, stirring occasionally, until the pasta is cooked through, about 15 minutes.
Step 6
Stir in the shredded cheese, red pepper flakes if using, and the spinach. Stir to combine until the cheese is melted.
Step 7
Return the sausage to the pan and stir to combine.
Step 8
Serve right away!