In my family we call this Nanny's hash after my father's mother. She made it with ground beef. For lunch today I made it with leftover pot roast. Holy Toledo, I wish I were still eating it.
I chopped an onion and two cloves of garlic and sweated it all in some olive oil (with some salt). Meanwhile I boiled water, salted it heavily, and dropped in some elbow macaroni. Salt, salt, everywhere. I chopped some of last night's pot roast up into very itsy bits and added it to the pan, stirring and mashing with my wooden spoon to make it fall completely apart. I added some Prego traditional and stirred it all together.
I drained the pasta, tossed it with the onion-garlic-tomato-sauce-pot-roast mixture in the pan, drizzled on some more olive oil, and served it to myself for lunch with a wee shaving of Pecorino cheese (sorry kosher folks) and a few shakes of red chile flakes. Dee Lish.