While the age of the 10th child who died was not given, the ages of the first nine patients who succumbed to the virus ranged from toddler to young adults, majority under 18.
"The loss of these young lives is heartbreaking", New Jersey's health commissioner, Dr. Shereef Elnahal, said in a statement.
Officials have said there is not a wider public health concern stemming from the outbreak.
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Wanaque Center for Nursing and Rehabilitation has pushed back against the former patient's claims, citing its record of being ranked in the top ten percent of nursing facilities in the U.S.
Meanwhile, the state says there are four confirmed adenovirus cases among pediatric patients at Voorhees Pediatric Facility, near Philadelphia. The Department will not consider the outbreak over until four weeks after the last illness onset.
Preliminary tests have ruled out the strain linked to the 10 deaths at the Wanaque facility. People with weakened immune systems, or existing respiratory or cardiac disease, are at higher risk of developing severe illness from an adenovirus infection, according to the Centers for Disease Control and Prevention. It can cause mild cold or flu symptoms, and some strains also cause diarrhea and pinkeye. It sometimes causes more serious respiratory illness, especially among those with weak immune systems.
"Now that the report is finalized, certain findings raise questions about whether these general long-term care standards are optimal for this vulnerable population of medically fragile children", Elnahal said. The facility has agreed not to accept new patients as the outbreak is investigated, the health department said.