In a large skillet set over medium high heat, melt 1 tablespoon butter. Add sausage and cook until browned, about 5 minutes. Transfer sausage to a paper towel-lined plate to drain and set aside.
Add the penne pasta, minced garlic, salt, pepper, and water to skillet and bring to a boil. Cook for 7 minutes, stirring frequently.
Add chopped broccoli and heavy cream and cook for 5 minutes more, stirring frequently.
Add remaining 4 tablespoons of butter, parmesan cheese, and sausage, and cook for 1-2 minutes until pasta is al dente and sauce is smooth.
Serve immediately with additional Parmesan cheese.
Calories: 653kcal, Carbohydrates: 49g, Protein: 23g, Fat: 41g, Saturated Fat: 20g, Cholesterol: 114mg, Sodium: 1005mg, Potassium: 548mg, Fiber: 4g, Sugar: 3g, Vitamin A: 1238IU, Vitamin C: 69mg, Calcium: 223mg, Iron: 2mg