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Family friend moved in with my mother after she returned home from the rehab, she helps her around the house. My mom has a nurse, and physical therapist that comes by 3 times a week. Should we pay this lady and have her sign a lease agreement?

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No. Make sure this is a temporary arrangement and she leaves soon. Clear that up ASAP or you will have a permanent tenant that you cannot remove.
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Did Mom or family ask friend to move to help out? Does your Mom need someone with her 24/7? Or did this friend just volunteer to come in and help for a while? Does friend have her own home or permanent living arrangement?

Sit down with her and make an agreement as to how long she is staying and what responsibilities are required. If she was asked to move in then I think she needs to be paid; if a volunteer situation then a nice gift card or personal gift is appropriate when she finishes her time with Mom. Definitely an end date for her services is required asap..
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Not enough information here.

Is Mother in her right mind? She can certainly decide who lives with her, or how long her "guests" stay.

How much help does mother need? The physical therapist visits will not last long. The nurse is not going to be preparing meals or sitting and visiting or helping with the laundry.

Has this family friend been close to Mother for a long time? Have they helped each other out in the past?

What was Mother in rehab for? Is she expected to fully recover functionality? Any idea of how long that will take?

Has mother suggested that this friend be paid? Is it mother's money that would be used?

Just not enough information for informed suggestions.

(If a friend of mine moved in to help me out after I returned from a medical event, you'd better believe I would not allow my children to dictate how long she could stay! But that works in my situation. We don't know what your mother's situation is.)
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Oh, and who has Mother's power of attorney?
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Who's "we"? As in, should we pay this lady.

Whose idea was it that she should move in?

What was the understanding among the various parties - the friend, your mother, the rest of the family - when this arrangement was made?
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If it is a temp situation, I would just get an informal 'note' that she signs saying when she expects to leave - and whether she expects payment, include that. If your mother is wanting her there permanently, you need a formal agreement as to the rent she would pay and what will happen if your mother goes into nursing care.

If she is just staying for a short while and is helping out, I would at least give her a gift that she could use, or some cash. After all, she is doing jobs that someone else ( you) would have to do.
You just need to find out what her expectations are about how long she will be there.
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