• Crumble sausage into large saucepan. Add 2 tbsp cold water; cook over medium-high heat, turning occasionally, for 3 minutes or until browned. Remove with slotted spoon; set aside. Pour off and discard any drippings.
• Add oil; heat until warm. Add garlic and sage; cook for about 1 minute or until fragrant. Add beans; cook, stirring, for 1 minute. Add broth and 4 cups water. Increase heat to high and bring just to boil, scraping up browned bits at the bottom of saucepan.
• Reduce heat to medium-low; cover partially and simmer for 15 minutes. In blender or food processor, purée half of the beans and enough broth to cover. Return to saucepan; add macaroni and reserved sausage. Simmer for about 5 minutes or until macaroni is al dente. Stir in spinach, vinegar, salt and pepper. Ladle into bowls; sprinkle with Pecorino Romano.

Recipe Provided by Chef Sharon Sanders