**Cook the Pasta:**

Boil the pasta in salted water according to package instructions. Reserve 1 cup of pasta water, then drain and set aside.

**Cook the Sausage:**

Heat olive oil in a large skillet over medium heat. Add the sausage and cook until browned and crumbled. Remove the sausage with a slotted spoon and set aside.

**Prepare the Sauce:**

In the same skillet, add the butternut squash, onion, and garlic. Sauté for 5–7 minutes until softened. Add the broth and bring to a simmer. Cook until the squash is tender, about 10 minutes.

**Blend the Sauce:**

Transfer the squash mixture to a blender or use an immersion blender to puree it until smooth. Return the sauce to the skillet and stir in the heavy cream, Parmesan cheese, nutmeg, and reserved pasta water as needed for consistency.

**Combine the Ingredients:**

Add the cooked sausage and spinach to the skillet, stirring until the spinach wilts. Toss in the cooked pasta and mix until everything is coated in the creamy sauce.

**Serve:**

Season with salt and pepper to taste. Garnish with fresh parsley and additional Parmesan cheese, if desired.