Cook the Sausage:
In a large pot or Dutch oven, cook the sausage over medium heat, breaking it apart with a spoon as it cooks. Cook until browned and crumbled, about 5-7 minutes. Remove any excess grease if necessary.

Sauté the Vegetables:
Add the diced onion to the pot with the sausage and cook for 3-4 minutes, until softened. Add the minced garlic, oregano, and red pepper flakes (if using) and cook for another minute, until fragrant.

Add the Broth and Tomatoes:
Pour in the chicken broth and diced tomatoes with their juice. Stir to combine, scraping any browned bits off the bottom of the pot.

Simmer the Soup:
Bring the soup to a simmer and cook for 5-7 minutes to allow the flavors to blend.

Add the Cream and Milk:
Stir in the heavy cream and milk. Bring the mixture back to a simmer, then add the tortellini. Cook according to package directions, usually about 5-7 minutes, until the tortellini are tender and cooked through.

Add the Spinach:
Stir in the chopped spinach and cook for 2-3 minutes, until wilted.

Season and Serve:
Taste the soup and add salt and pepper as needed. Ladle the soup into bowls and garnish with shredded Parmesan cheese and fresh parsley, if desired.

Enjoy!
Serve hot and enjoy the creamy, comforting flavors!