In a pot with olive oil, add in the ground sausage, mash it up, and let that saute for 2 minutes.

Add in the onions, garlic, dried basil, italian seasoning, garlic powder, crushed red pepper flakes, and salt & pepper. Saute that together for 5-7 minutes until cooked through.

Then add in tomato paste and saute it for about 1 minute. Shake over the flour and whisk continuously for 2 minutes. Bring the pot to a boil, pour in the chicken stock, and continue whisking continuously for 2-3 minutes. Once the pot comes to a boil, lower it to a simmer.

Bring the pot to a boil, once it comes to a boil, stir in the crushed tomatoes and heavy cream. Lower the pot to a medium heat and let it cook for about 10-15 minutes.

Bring the pot to a low simmer, add the pecorino romano, then bring the pot to a boil. Once it comes to a boil, add in the tortellini, and let that boil for about 5 minutes or until the tortellini is al dente.

Then add in the spinach and 2 tbsp of pecorino romano, stir that together, and you're ready to serve!