Heat a large pan over medium-high heat, add the sausage, and break it into small crumbles with a wooden spoon. When the meat begins to color and its moisture cooks away, lower the heat to medium.

Cook the sausage until browned throughout, then transfer it from the pan to a bowl. Leave the flavorful browned bits behind, but avoid carrying an excessive pool of rendered grease into the finished gravy.

Add the cream cheese, heavy whipping cream, ground black pepper, and water or broth to the same pan, then whisk over medium heat. Keep whisking until the cream cheese fully dissolves and the sauce looks smooth with no pale lumps.

Return the browned sausage to the creamy mixture. The crumbles should spread evenly through the gravy rather than clump at the bottom of the pan.

Let the gravy simmer for a few minutes, then remove the pan from the heat. It is ready when the sauce clings to the back of a spoon in clean, creamy lines.

Transfer any leftover gravy to an airtight container after serving. The gravy will firm up as it cools because the dairy and sausage fat set.