SCHEDULE 13D/A 0000950157-25-000967 0000918697 XXXXXXXX LIVE 1 Common Stock, par value $0.001 02/23/2026 true 0001320414 81619Q105 SELECT MEDICAL HOLDINGS CORP

4714 Gettysburg Road, P.O. Box 2034 Mechanicsburg PA 17055

Robert A. Ortenzio (717) 972-1100 4714 Gettysburg Road, P.O. Box 2034 Mechanicsburg PA 17055 0000918697 ORTENZIO ROBERT A a OO X1 7081788 6937947 7081788 6937947 14019735 N 11.3 IN 1. Items 8, 10, 11 and 13 include 7,081,788 shares over which the Reporting Person has the sole power to vote and dispose of as well as the following shares that the Reporting Person may be deemed to beneficially own, as the Reporting Person may be deemed to have current shared power to vote or direct the vote of and to dispose of or direct the disposition therefor: (a) 200,000 shares held by the Robert and Angela Ortenzio Family Foundation, of which the Reporting Person is a co-trustee, (b) 532,152 shares held by the Rocco and Nancy Ortenzio Family Foundation, of which the Reporting Person is a co-trustee, (c) 1,279,000 shares owned by the Robert A. Ortenzio Descendants Trust, for which the Reporting Person serves as a member of the board of directors of Select Asset Management & Trust LLC (the "Select Trustee"), a co-trustee, (d) 280,415 shares held by the Robert A. Ortenzio April 2014 Trust for Kevin M. Ortenzio, for which the Reporting Person serves as a member of the board of directors of the Select Trustee, a co-trustee, (e) 280,415 shares held by the Robert A. Ortenzio April 2014 Trust for Bryan A. Ortenzio for which Mr. Robert A. Ortenzio, for which the Reporting Person serves as a member of the board of directors of the Select Trustee, a co-trustee, (f) 280,415 shares held by the Robert A. Ortenzio April 2014 Trust for Madeline G. Ortenzio, for which the Reporting Person serves as a member of the board of directors of the Select Trustee, a co-trustee, (g) 4,028,767 shares held by the Rocco A. Ortenzio Revocable Trust, of which the Reporting Person is a co-trustee, (h) 16,182 shares beneficially owned by the Estate of Rocco A. Ortenzio through Select AP Investors, L.P., for which the Reporting Person may be deemed to exercise control in his capacity as a trustee of such Estate, (i) 30,601 shares beneficially owned by the Estate of Rocco A. Ortenzio through Select Investments III, L.P., for which the Reporting Person may be deemed to exercise control in his capacity as a trustee of such Estate, and (j) 10,000 shares held by the spouse of the deceased Rocco A. Ortenzio, over which the Reporting Person shares a power of attorney. 2. The percentage in Item 13 is based on 124,017,191 Common Stock shares outstanding of Select Medical Holdings Corporation as of February 1, 2026. Y JACKSON MARTIN F a OO X1 1383421 2634 1383421 2634 1383421 Y 1.1 IN 1. Items 8 and 10 contain 2,634 shares beneficially owned by the Reporting Person's child over whom the Reporting Person is a court-appointed guardian. The Reporting Person disclaims beneficial ownership in all such shares. 2. The percentage in Item 13 is based on 124,017,191 Common Stock shares outstanding of Select Medical Holdings Corporation as of February 1, 2026. Y ESTATE OF ROCCO A. ORTENZIO a OO X1 0 4085550 0 4085550 4085550 N 3.3 OO 1. Items 8, 10, 11 and 13 include the following shares that the Reporting Person may be deemed to beneficially own, as the Reporting Person may be deemed to have current shared power to vote or direct the vote of and to dispose of or direct the disposition therefor: (a) 4,028,767 shares held by the Rocco A. Ortenzio Revocable Trust, (b) 16,182 shares held by Select AP Investors, L.P., (c) 30,601 shares held through Select Investments III, L.P., and (d) 10,000 shares held by the spouse of the deceased Rocco A. Ortenzio. 2. The percentage in Item 13 is based on 124,017,191 Common Stock shares outstanding of Select Medical Holdings Corporation as of February 1, 2026. Common Stock, par value $0.001 SELECT MEDICAL HOLDINGS CORP 4714 Gettysburg Road, P.O. Box 2034 Mechanicsburg PA 17055 This Schedule 13D constitutes Amendment No. 1 to the Schedule 13D filed as of November 24, 2025 (the "Original Schedule 13D"), which relates to the Common Stock shares, par value $0.001 (the "Shares"), issued by Select Medical Holdings Corp (the "Issuer"). The Issuer's principal executive office is located at 4714 Gettysburg Road, Mechanicsburg, Pennsylvania 17055. The reporting persons (each, a "Reporting Person" and, collectively, the "Reporting Persons") are: Robert A. Ortenzio, c/o Select Medical Holdings Corporation, 4714 Gettysburg Road, P.O. Box 2034, Mechanicsburg, Pennsylvania 17055 Martin F. Jackson. c/o Select Medical Holdings Corporation, 4714 Gettysburg Road, P.O. Box 2034, Mechanicsburg, Pennsylvania 17055 Estate of Rocco A. Ortenzio, c/o Select Medical Holdings Corporation, 4714 Gettysburg Road, P.O. Box 2034, Mechanicsburg, Pennsylvania 17022 See (a) above. Robert A. Ortenzio co-founded the Issuer and his present principal occupation or employment is serving as Executive Chairman of the Board of Directors (the "Board") of the Issuer. Martin F. Jackson's present principal occupation or employment is serving as Senior Executive Vice President of Strategic Finance and Operations of the Issuer. Rocco A. Ortenzio co-founded the Issuer and was Vice Chairman and Co-Founder of the Issuer. Rocco A. Ortenzio passed away on October 26, 2024. During the past five years, none of the Reporting Persons have (i) been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) nor (ii) been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction and, as a result of such proceeding, was or is subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws. See (d) above. Citizenship: Robert A. Ortenzio - United States Martin F. Jackson - United States Estate of Rocco A. Ortenzio - United States The Shares held by Mr. Ortenzio were issued to him as compensation for his roles as officer and director of the Issuer, as well as Shares owned prior to the initial public offering of the Shares of the Issuer as co-founder of the Issuer. The Shares held by Mr. Jackson were issued to him as compensation for his role as an officer and employee of the Issuer. The Shares held by the Estate of Rocco A. Ortenzio were Shares issued to Rocco A. Ortenzio as compensation for his roles as officer and director of the Issuer, as well as Shares owned prior to the initial public offering of the Shares of the Issuer as co-founder of the Issuer. Item 4 of the Original Schedule 13D is hereby amended and supplemented to incorporate the following: On February 22, 2026, Mr. Ortenzio delivered a refined non-binding proposal (the "Refined Proposal Letter") to the Special Committee of the Board to offer to acquire all outstanding Shares of the Issuer not already owned by the Reporting Persons at a price of $16.00 per share, payable in cash (the "Refined Proposal"). The foregoing description of the Refined Proposal Letter does not purport to be complete and is qualified in its entirety by reference to the full text of the Refined Proposal Letter, which is filed as Exhibit 99.3 hereto and is incorporated by reference into this Item 4. There can be no assurance that any discussions that may occur between the Reporting Persons and the Issuer with respect to the Refined Proposal will result in the entry into a definitive agreement concerning a transaction or, if such a definitive agreement is reached, will result in the consummation of a transaction provided for in such definitive agreement. Discussions concerning a transaction may be terminated at any time and without prior notice. Entry into a definitive agreement concerning a transaction and the consummation of any such transaction will be subject to a number of contingencies that are beyond the control of the Reporting Persons, including the approval of the Special Committee, and the satisfaction of any conditions to the consummation of a transaction set forth in any such definitive agreement, including receipt of all necessary regulatory approvals. The aggregate number and percentage of Shares beneficially owned by each Reporting Person (on the basis of a total of 124, 017,191 Shares outstanding of the Issuer as of February 1, 2026) is as follows: Robert A. Ortenzio (a) The following amount of shares may be deemed beneficially owned by Mr. Ortenzio: 14,019,735; Percentage: 11.3%. (b) Mr. Ortenzio may be deemed to have (i) the sole power to vote or direct the vote of and to dispose of or to direct the disposition of 7,081,788 Shares and (ii) the current shared power to vote or direct the vote of and to dispose of or direct the disposition of 6,937,947 Shares (including (a) 200,000 Shares held by the Robert and Angela Ortenzio Family Foundation, of which the Mr. Ortenzio is a co-trustee, (b) 532,152 Shares held by the Rocco and Nancy Ortenzio Family Foundation, of which the Mr. Ortenzio is a co-trustee, (c) 1,279,000 Shares owned by the Robert A. Ortenzio Descendants Trust, for which the Mr. Ortenzio serves as a member of the board of directors of Select Asset Management & Trust LLC (the "Select Trustee"), a co-trustee, (d) 280,415 Shares held by the Robert A. Ortenzio April 2014 Trust for Kevin M. Ortenzio, for which the Mr. Ortenzio serves as a member of the board of directors of the Select Trustee, a co-trustee, (e) 280,415 Shares held by the Robert A. Ortenzio April 2014 Trust for Bryan A. Ortenzio for which Mr. Robert A. Ortenzio, for which the Mr. Ortenzio serves as a member of the board of directors of the Select Trustee, a co-trustee, (f) 280,415 Shares held by the Robert A. Ortenzio April 2014 Trust for Madeline G. Ortenzio, for which the Mr. Ortenzio serves as a member of the board of directors of the Select Trustee, a co-trustee, (g) 4,028,767 Shares held by the Rocco A. Ortenzio Revocable Trust, of which the Mr. Ortenzio is a co-trustee, (h) 16,182 Shares beneficially owned by the Estate of Rocco A. Ortenzio through Select AP Investors, L.P., for which the Reporting Person may be deemed to exercise control in his capacity as a trustee of such Estate, (i) 30,601 Shares beneficially owned by the Estate of Rocco A. Ortenzio through Select Investments III, L.P., for which the Reporting Person may be deemed to exercise control in his capacity as a trustee of such Estate, and (j) 10,000 Shares held by the spouse of the deceased Rocco A. Ortenzio, over which the Mr. Ortenzio Shares a power of attorney). Martin F. Jackson (a) Amount of shares beneficially owned: 1,383,421; Percentage: 1.1%. (b) Mr. Jackson may be deemed to have (i) the sole power to vote or to direct the vote of and to dispose or direct the disposition of 1,383,421 Shares and (ii) the shared power to vote or to direct the vote of and to dispose or direct the disposition of 2,634 Shares held by Mr. Jackson's child, over whom he is a court-appointed guardian. Mr. Jackson disclaims the beneficial ownership of all Shares not directly owned by him. The Estate of Rocco A. Ortenzio (a) Amount of shares beneficially owned: 4,085,550; Percentage: 3.3%. (b) The Estate of Rocco A. Ortenzio may be deemed to have the current shared power to vote or direct the vote of and to dispose of or direct the disposition of 6,937,947 Shares (including (a) 4,028,767 Shares held by the Rocco A. Ortenzio Revocable Trust, (b) 16,182 shares held by Select AP Investors, L.P., (c) 30,601 Shares held through Select Investments III, L.P., and (d) 10,000 Shares held by the spouse of the deceased Rocco A. Ortenzio). No transactions in Issuer Stock were affected by, or with respect to, the Reporting Persons listed in Item 2 within the past 60 days. The Reporting Persons have the right to receive distributions from, and the proceeds from the sale of, the respective Shares reported by such persons on the cover pages of the Schedule 13D and in this Item 5. Except for the foregoing, no other person is known by the Reporting Persons to have the right to receive or the power to direct the receipt of distributions from, or the proceeds from the sale of, shares beneficially owned by the Reporting Persons or, to the Reporting Persons' knowledge, the Listed Persons. Not applicable. The information set forth in Items 3, 4, and 5 (a)-(b) is hereby incorporated by reference in this Item 6. The descriptions of the any contracts, arrangements, understandings, or relationships in Items 3, 4, and 5(a)-(b) in this Item 6 are not intended to be complete and are qualified in their entirety by reference to such documents and descriptions and are hereby incorporated herein by reference. Item 7 of the Original Schedule 13D is hereby amended and supplemented to incorporate the following: The following document is filed as an exhibit: --------------- Exhibit 99.3 - Refined Proposal Letter, date February 22, 2026 ORTENZIO ROBERT A /s/ Robert A. Ortenzio 02/23/2026 JACKSON MARTIN F /s/ Martin F. Jackson 02/23/2026 ESTATE OF ROCCO A. ORTENZIO /s/ Robert A. Ortenzio 02/23/2026